Healthcare Provider Details

I. General information

NPI: 1427768779
Provider Name (Legal Business Name): MALIKA GOEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2022
Last Update Date: 06/25/2024
Certification Date: 06/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 16TH STREET, FLOOR 4, BOX 0110 BOX 0110
SAN FRANCISCO CA
94158
US

IV. Provider business mailing address

550 16TH ST FL 4 BOX 0110
SAN FRANCISCO CA
94158-2545
US

V. Phone/Fax

Practice location:
  • Phone: 415-502-3243
  • Fax:
Mailing address:
  • Phone: 415-502-3243
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA195620
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2080P0206X
TaxonomyPediatric Gastroenterology Physician
License NumberA195620
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4351049202
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: