Healthcare Provider Details

I. General information

NPI: 1154579498
Provider Name (Legal Business Name): NISHI KAUR BHOPAL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 SACRAMENTO ST
SAN FRANCISCO CA
94118-1709
US

IV. Provider business mailing address

3609 SACRAMENTO ST
SAN FRANCISCO CA
94118-1709
US

V. Phone/Fax

Practice location:
  • Phone: 415-237-0377
  • Fax: 415-484-1944
Mailing address:
  • Phone: 415-237-0377
  • Fax: 415-484-1944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084S0012X
TaxonomySleep Medicine (Psychiatry & Neurology) Physician
License Number142164
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number142164
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: