Healthcare Provider Details

I. General information

NPI: 1033405592
Provider Name (Legal Business Name): ANURAG GOEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2011
Last Update Date: 05/31/2026
Certification Date: 05/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12700 INGLEWOOD AVE UNIT 62
HAWTHORNE CA
90251-2407
US

IV. Provider business mailing address

12700 INGLEWOOD AVE UNIT 62
HAWTHORNE CA
90251-2407
US

V. Phone/Fax

Practice location:
  • Phone: 858-386-2322
  • Fax: 415-854-9551
Mailing address:
  • Phone: 858-386-2322
  • Fax: 415-854-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC148442
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: