Individual provider Active NPI

Pooja Gupta, DO

  • Family Medicine Physician
  • Colton, CA
National Provider Identifier
1497762355
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A8214 Issued in CA
Practice address
400 N Pepper Ave
Arrowhead Regional Medical Center
Colton, CA 92324-1819
Phone
(909) 580-6240
Fax
(909) 580-6308
NPI assigned
Aug 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 20A8214 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Arrowhead Regional Medical Center
Colton, CA 92324-1819

Mailing address

PO Box 5157
San Bernardino, CA 92412-5157
Phone (909) 580-6240

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
I20040726001110 CA Practitioner - Family Practice 7416927710 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Vituity Physician Services PC 58 clinicians
Vituity Healthcare Services PC 27 clinicians
County of San Bernardino 76 clinicians

Practice addresses (Care Compare)

16888 Baseline Ave
Fontana, CA 92336-2083
Phone (855) 422-8029

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

Hospital & facility affiliations

  • Arrowhead Regional Medical Center Hospital, Colton, CA, CCN 050245

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
20A8214CAMDFamily Medicine Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
County of San Bernardino Current Accepting new patients
Vituity Healthcare Services PC Family Medicine CurrentSince May 1, 2024 Accepting new patients
Vituity Physician Services PC Family Medicine CurrentSince May 1, 2024 Accepting new patients

Locations

400 N Pepper Ave
Ste 301
Colton, CA 92324
Phone (909) 580-3366

400 N Pepper Ave
Colton, CA 92324
Phone (909) 580-1800

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1499 E Highland Ave
Sn Bernrdno, CA 92404
Phone (855) 422-8029

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 11

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.

Hospital & facility affiliations 1

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": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497762355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5157",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924125157",
            "telephone_number": "909-580-6240",
            "fax_number": "909-580-6308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "ARROWHEAD REGIONAL MEDICAL CENTER",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241819",
            "telephone_number": "909-580-6240",
            "fax_number": "909-580-6308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUPTA",
        "first_name": "POOJA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A8214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.