# DAVID R. GOTHAM, JR., D.O., INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114110640
- **Authorized official:** DR. DAVID R GOTHAM JR. D.O. (PRESIDENT)
- **Authorized official phone:** (916) 616-0510

## Contact information

- **Practice address:** 2204 PLAZA DR, SUITE 210, ROCKLIN, CA 95765-4413
- **Practice address phone:** (916) 771-9555
- **Practice address fax:** (916) 771-9556
- **Mailing address:** 7855 WINGATE CT, GRANITE BAY, CA 95746-9362
- **Mailing address phone:** (916) 791-9510

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 20A8894 | CA | Yes |

## Other

- **Enumeration date:** 08/17/2007
- **Last updated:** 07/30/2009