Provider Demographics
NPI:1174586531
Name:GUPTA, RAMESH CHANDER (MD)
Entity type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:CHANDER
Last Name:GUPTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1805
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93302
Mailing Address - Country:US
Mailing Address - Phone:661-864-3664
Mailing Address - Fax:661-328-0316
Practice Address - Street 1:1408 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309
Practice Address - Country:US
Practice Address - Phone:661-327-4455
Practice Address - Fax:661-633-3976
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA045356174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0054270Medicaid
CA00A453560Medicare ID - Type UnspecifiedFEDERAL
CAF03402Medicare UPIN