Provider Demographics
NPI:1083778765
Name:HOPKINS, KEITH ALFRED (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:ALFRED
Last Name:HOPKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3010 BEARD RD
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3442
Mailing Address - Country:US
Mailing Address - Phone:707-255-8825
Mailing Address - Fax:707-252-9325
Practice Address - Street 1:500 UNIVERSITY AVE STE 112
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-6514
Practice Address - Country:US
Practice Address - Phone:916-570-2850
Practice Address - Fax:916-570-2854
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-20
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC141874207R00000X, 208D00000X
CA141874207R00000X
IL036124262207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty