Healthcare Provider Details

I. General information

NPI: 1003477837
Provider Name (Legal Business Name): MOHIT KUMAR GOSAI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2019
Last Update Date: 09/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2419 OPHIR STREET
STOCKTON CA
95206
US

IV. Provider business mailing address

6653 EMBARCADERO DR # Z
STOCKTON CA
95219-3397
US

V. Phone/Fax

Practice location:
  • Phone: 510-780-6328
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberF1402992
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code146M00000X
TaxonomyIntermediate Emergency Medical Technician
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: