Provider Demographics
NPI:1063790632
Name:GUPTA, SAPNA RAISONI (MD)
Entity type:Individual
Prefix:DR
First Name:SAPNA
Middle Name:RAISONI
Last Name:GUPTA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SAPNA
Other - Middle Name:JAYPRAKASH
Other - Last Name:RAISONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1140 GUERRERO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-2933
Mailing Address - Country:US
Mailing Address - Phone:415-875-9058
Mailing Address - Fax:
Practice Address - Street 1:1140 GUERRERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-2933
Practice Address - Country:US
Practice Address - Phone:415-875-9058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00047406207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology