Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 276077 | NY |
NPI | 1003821430 |
---|---|
Provider Name | Dr. Sanjeev Gopal |
First Address | Mesa, AZ 85206-1750 |
Second Address | Mesa, AZ 85206-1750 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 04/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1003821430 | BLUE CROSS BLUE SHIELD (01) | AZ |
1710322946 | Z159340 (01) | AZ |
178311 | (05) | AZ |
206531 | UNIVERSAL (01) | AZ |
3Z4309 | HEALTH NET (01) | AZ |
5336171 | CIGNA (01) | AZ |
7905050 | AETNA (01) | AZ |
G95539 | (02) | |
P00853763 | RAILROAD MEDICARE (01) | AZ |