Provider Demographics
NPI:1902120488
Name:SUNEET K GUPTA INC
Entity Type:Organization
Organization Name:SUNEET K GUPTA INC
Other - Org Name:CHINO HILLS EYECARE OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:909-591-2034
Mailing Address - Street 1:3233 GRAND AVE
Mailing Address - Street 2:SUITE M
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-1489
Mailing Address - Country:US
Mailing Address - Phone:909-591-2034
Mailing Address - Fax:909-591-2176
Practice Address - Street 1:3233 GRAND AVE
Practice Address - Street 2:SUITE M
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-1489
Practice Address - Country:US
Practice Address - Phone:909-591-2034
Practice Address - Fax:909-591-2176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-26
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11457 TPL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACX 906AMedicare PIN