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General NPI Number Information
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NPI Number | 1932554045
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Entity Type | Individual
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Provider Name | GOPAL PATEL MD PHD
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Gender | Male
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 06/16/2022
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Provider Practice Location Address
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Address Line | 4400 V STREET, PATHOLOGY BUILDING
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City | SACRAMENTO
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State | CA
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Zip | 95817
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Country | US
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Telephone | 916-734-3331
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Fax | 916-734-6468
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Provider Business Mailing Address
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Address Line | 4301 NORTHSTAR WAY
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City | MODESTO
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State | CA
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Zip | 95356-7770
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Country | US
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Telephone | 209-577-1200
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Fax | 209-577-6517
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | A167152
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License Number State | CA
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