Avani R Gupta, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

20A11616 Issued in CA

Practice address

1950 E Los Angeles Ave
Simi Valley, CA 93065-3503

Phone

(805) 306-1440

Fax

(805) 306-1758

NPI assigned

Jun 5, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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

• Kanakavalli Suresh Iyer, M.D., Inc.

  • Anesthesiology Physician
  • Simi Valley, CA
  • NPI 1700250578
  NPD (past)

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393200000000",
    "number": "1396904249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 E LOS ANGELES AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653503",
            "telephone_number": "805-306-1440",
            "fax_number": "805-306-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E LOS ANGELES AVE",
            "city": "SIMI VALLEY",
            "state": "CA",
            "postal_code": "930653503",
            "telephone_number": "805-306-1440",
            "fax_number": "805-306-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "AVANI",
        "middle_name": "R",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-05",
        "last_updated": "2014-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A11616",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OSTEOPATHIC MEDICAL BOARD LICENSE",
            "identifier": "20A11616",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guiding Our Youth
• Guiding Our Youth
• Evette Guirguis, RPH
• Gerard Gumboc, P.T.
• Elaine Jean Gunn, RN
• Deepti Gupta, MD
• Vinod Kumar Gupta, M.D.
• Gurgen Abazyan, D.M.D, Inc.
• Gurgen Abazyan, D.M.D, Inc.
• Jerrold Guss, DMD

• Family Medicine Physician in Simi Valley, CA
• Providers in Simi Valley, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.