Healthcare Provider Details

I. General information

NPI: 1124949854
Provider Name (Legal Business Name): RENU GAHLAUT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 X ST
SACRAMENTO CA
95817-2214
US

IV. Provider business mailing address

4400 V ST
SACRAMENTO CA
95817-1445
US

V. Phone/Fax

Practice location:
  • Phone: 78-154-3217
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberSPI960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: