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General NPI Number Information
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NPI Number | 1952677379
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Entity Type | Organization
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Legal Business Name | KISHOR D POPAT, MD, A PROFESSIONAL CORP.
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 1505 SHEPARD DR STE 203
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City | SANTA MARIA
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State | CA
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Zip | 93454-7020
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Country | US
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Telephone | 805-922-6990
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Fax | 805-347-9920
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Provider Business Mailing Address
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Address Line | 1505 SHEPARD DR STE 203
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City | SANTA MARIA
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State | CA
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Zip | 93454-7020
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Country | US
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Telephone | 805-922-6990
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Fax | 805-347-9920
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Authorized Official
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Title or Position | OWNER
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Name | KISHOR D POPAT
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Credential | M D
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Telephone | 805-922-6990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | A39601
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License Number State | CA
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