Provider Demographics
NPI:1417955287
Name:HOPKINS, DONALD GREGORY (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:GREGORY
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 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:707-573-5200
Mailing Address - Fax:707-573-5417
Practice Address - Street 1:34 MARK WEST SPRINGS RD STE 310
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403
Practice Address - Country:US
Practice Address - Phone:707-573-5200
Practice Address - Fax:707-573-5417
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA413572207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C405700Medicaid
CARHD00125065OtherFLOUROSCOPY CERTIFCATION
CA40570OtherSTATE MEDICAL LICENSE
CA40570OtherSTATE MEDICAL LICENSE
CA00C405703Medicare PIN
CA00C405700OtherBLUE SHIELD OF CALIFORNIA
CAA37399Medicare UPIN
CA00C405705Medicare PIN
CA00C405704Medicare PIN
CA00C405702Medicare PIN
CA060015331OtherRAILROAD MEDICARE
CA00C405701Medicare PIN