Healthcare Provider Details

I. General information

NPI: 1841103116
Provider Name (Legal Business Name): PHILIP C GOBEL NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 STONEHOUSE CT
ROSEVILLE CA
95678-1904
US

IV. Provider business mailing address

1500 EXPO PKWY
SACRAMENTO CA
95815-4227
US

V. Phone/Fax

Practice location:
  • Phone: 916-469-4690
  • Fax:
Mailing address:
  • Phone: 916-469-4690
  • Fax: 916-313-8425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number95041683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: