Individual provider Active NPI

Neeraj Gupta, M.D.

  • Internal Medicine Physician
  • Long Beach, CA
National Provider Identifier
1356504062
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A104339 Issued in CA
Practice address
4300 Long Beach Blvd Ste 500
Long Beach, CA 90807-2023
Phone
(213) 440-1082
NPI assigned
Jul 3, 2008
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A104339 CA Primary

Addresses

Primary practice location

4300 Long Beach Blvd Ste 500
Long Beach, CA 90807-2023

Mailing address

PO Box 1740
Los Angeles, CA 90078-1740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191219000533 CA Practitioner - Internal Medicine 2769816057 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Alliance Wellness CareGroup PAC ID 8628421724, 6 clinicians

Practice addresses (Care Compare)

23388 Mulholland Dr
Woodland Hills, CA 91364-2733
Phone (747) 264-9202

2829 Oak Point Dr
Los Angeles, CA 90068-2033
Phone (213) 421-1715

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A104339CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Executive Medical Services, Inc Internal Medicine CurrentSince Jun 7, 2025 Accepting new patients
Alliance Wellness Care Internal Medicine CurrentSince Aug 9, 2024 Accepting new patients

Locations

16260 Ventura Blvd
Ste 630
Encino, CA 91436
Phone (747) 264-9201

23388 Mulholland Dr
Woodland Hls, CA 91364
Phone (818) 876-1050

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
St. Arsenius Hospice Care, IncPasadena, CA, CCN 751711 Hospice Contracted Managing Employee Mar 17, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1356504062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1740",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900781740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4300 LONG BEACH BLVD STE 500",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908072023",
            "telephone_number": "213-440-1082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "NEERAJ",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A104339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.