Healthcare Provider Details

I. General information

NPI: 1417955287
Provider Name (Legal Business Name): DONALD GREGORY HOPKINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 MARK WEST SPRINGS RD STE 310
SANTA ROSA CA
95403
US

IV. Provider business mailing address

325 DISTEL CIR
LOS ALTOS CA
94022-1408
US

V. Phone/Fax

Practice location:
  • Phone: 707-573-5200
  • Fax: 707-573-5417
Mailing address:
  • Phone: 707-573-5200
  • Fax: 707-573-5417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number413572
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number413572
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: