Active NPI
Sunil Gupta, D.O.
- Rheumatology Physician
- Laguna Hills, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 20A12640
- Practice address
- 26538 Moulton Pkwy Ste 38E
Laguna Hills, CA 92653 - Phone
- (949) 448-0656
- NPI assigned
- Jun 17, 2008
- Last updated
- Jul 19, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | OT012678 | PA | |
| Internal Medicine Physician | 207R00000X | 20A12640 | CA | |
| Rheumatology Physician | 207RR0500X | 20A12640 | CA | Primary |
Addresses
Primary practice location
26538 Moulton Pkwy Ste 38E
Laguna Hills, CA 92653
Mailing address
26538 Moulton Pkwy Ste 38E
Laguna Hills, CA 92653-8232
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437310059 | Other | CA | MEDI-CAL |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12640 | CA | MD | Counselor |
| 20A12640 | CA | MD | Internal Medicine Physician |
| OT012678 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorialcare Medical Foundation | Internal Medicine | Current | Accepting new patients |
Locations
722 Baker St
Costa Mesa, CA 92626
Phone (714) 557-6300
17360 Brookhurst St
Fountain Vly, CA 92708
Phone (657) 241-3592
26538 Moulton Pkwy
Ste 38E
Laguna Hills, CA 92653
Phone (949) 448-0656
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531958400000",
"number": "1437310059",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26538 MOULTON PKWY STE 38E",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "926538232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26538 MOULTON PKWY STE 38E",
"city": "LAGUNA HILLS",
"state": "CA",
"postal_code": "92653",
"telephone_number": "949-448-0656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUPTA",
"first_name": "SUNIL",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-17",
"last_updated": "2018-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "OT012678",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CA",
"license": "20A12640",
"primary": false
},
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "CA",
"license": "20A12640",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "1437310059",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Laguna Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.