Healthcare Provider Details

I. General information

NPI: 1629042254
Provider Name (Legal Business Name): RAKESH KUMAR GOYAL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2006
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 IRIS STREET
REDWOOD CITY CA
94062-2050
US

IV. Provider business mailing address

303 IRIS STREET
REDWOOD CITY CA
94062-2050
US

V. Phone/Fax

Practice location:
  • Phone: 412-980-6737
  • Fax: 816-302-9939
Mailing address:
  • Phone: 412-980-6737
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License NumberC167666
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberC167666
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: