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General NPI Number Information
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NPI Number | 1548235823
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Entity Type | Individual
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Provider Name | GREGORY BARTLETT KUGEL MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 02/13/2020
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Provider Practice Location Address
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Address Line | 3000 Q ST FL 1
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City | SACRAMENTO
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State | CA
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Zip | 95816-7058
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Country | US
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Telephone | 916-733-3301
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Fax | 916-281-3882
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Provider Business Mailing Address
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Address Line | 3400 DATA DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-7956
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Country | US
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Telephone | 916-379-2871
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Fax | 916-853-4730
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | ME91437
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | ME91437
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | C54627
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License Number State | CA
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