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General NPI Number Information
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NPI Number | 1508371873
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Entity Type | Individual
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Provider Name | PRATIK SHIRISH GOVIND MSHS, PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/08/2017
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 795 EL CAMINO REAL
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City | PALO ALTO
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State | CA
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Zip | 94301-2302
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Country | US
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Telephone | 650-853-2943
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 276950
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City | SACRAMENTO
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State | CA
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Zip | 95827-6950
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Country | US
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Telephone |
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Fax | 925-482-8239
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110005879
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | C0006547
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 54756
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA031389
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License Number State | DC
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