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NPI Code Detail

MEDICARE: KISHOR D POPAT M. D.

MEDICARE: KISHOR D POPAT M. D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1174400000XSpecialistA 39601CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A 39601OTHERCASTATE LICENSE

General Provider Information

NPI Number : 1245370105
Entity Type Code : Individual
Provider Name (Legal Business Name) : KISHOR D POPAT M. D.
Provider Business Mailing Address
First Line : 1505 SHEPARD DR
Second Line : SUITE 203
City : SANTA MARIA
State : CA
Zip : 93454-7020
Country : US
Telephone Number : 805-922-6990
Fax Number : 805-347-9920
Provider Business Practice Location Address
First Line : 1505 SHEPARD DR
Second Line : SUITE 203
City : SANTA MARIA
State : CA
Zip : 93454-7020
Country : US
Telephone Number : 805-922-6990
Fax Number : 805-347-9920
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2007
Last Update Date : 07/08/2007

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Directions to “ KISHOR D POPAT M. D.” Practice Location

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