Healthcare Provider Details

I. General information

NPI: 1487188280
Provider Name (Legal Business Name): STEPHEN HOPKINS MD MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2017
Last Update Date: 04/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

680 GUZZI LN SUITE 103
SONORA CA
95370-5288
US

IV. Provider business mailing address

680 GUZZI LN SUITE 103
SONORA CA
95370-5288
US

V. Phone/Fax

Practice location:
  • Phone: 209-532-5528
  • Fax: 209-532-5598
Mailing address:
  • Phone: 209-532-5528
  • Fax: 209-532-5598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. STEPHEN JAMES HOPKINS
Title or Position: PRESIDENT AND TREASURER
Credential: M.D.
Phone: 209-532-5528