Basic Information
Provider Information
NPI: 1558385997
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DHAWAN
FirstName: KAPIL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1300 ETHAN WAY STE 600
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958252296
CountryCode: US
TelephoneNumber: 9166793590
FaxNumber: 9164823647
Practice Location
Address1: 1508 ALHAMBRA BLVD STE 200
Address2:  
City: SACRAMENTO
State: CA
PostalCode: 958166510
CountryCode: US
TelephoneNumber: 9163251040
FaxNumber: 9166694100
Other Information
ProviderEnumerationDate: 07/27/2006
LastUpdateDate: 10/19/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/19/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XA116493CAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RP1001XA116493CAN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RS0012XA116493CAN Allopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
207RC0200XA116493CAY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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