Healthcare Provider Details

I. General information

NPI: 1265798680
Provider Name (Legal Business Name): ANUBHAV KAPOOR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2012
Last Update Date: 07/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 J ST
SACRAMENTO CA
95819-3626
US

IV. Provider business mailing address

3939 J ST STE 310
SACRAMENTO CA
95819-3666
US

V. Phone/Fax

Practice location:
  • Phone: 916-733-6990
  • Fax:
Mailing address:
  • Phone: 916-733-6990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberA148593
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: