Active NPI
Sundeep Gopal
- Pharmacist
- Mercer Island, WA
National Provider Identifier
1013279991
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00053805
- Practice address
- 2755 77TH Ave SE
Mercer Island, WA 98040-2811 - Phone
- (206) 232-2222
- Fax
- (206) 232-6485
- NPI assigned
- Jun 15, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00053805 | WA | Primary |
Addresses
Primary practice location
2755 77TH Ave SE
Mercer Island, WA 98040-2811
Mailing address
2755 77TH Ave SE
Mercer Island, WA 98040-2811
Phone (206) 232-2222
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00053805 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339718400000",
"number": "1013279991",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2755 77TH AVE SE",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980402811",
"telephone_number": "206-232-2222",
"fax_number": "206-232-6485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2755 77TH AVE SE",
"city": "MERCER ISLAND",
"state": "WA",
"postal_code": "980402811",
"telephone_number": "206-232-2222",
"fax_number": "206-232-6485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOPAL",
"first_name": "SUNDEEP",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-06-15",
"last_updated": "2012-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00053805",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mercer Island, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.