Healthcare Provider Details
I. General information
NPI: 1033180203
Provider Name (Legal Business Name): RAHUL SOMANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 01/27/2006
Last Update Date: 02/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5424 HEATHERLAND DR
SAN RAMON CA
94582-5054
US
IV. Provider business mailing address
5424 HEATHERLAND DR
SAN RAMON CA
94582-5054
US
V. Phone/Fax
- Phone: 925-786-1402
- Fax: 925-968-1323
- Phone: 925-786-1402
- Fax: 925-968-1323
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | G87607 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | P9260 |
| License Number State | TX |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | P9260 |
| License Number State | TX |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | G87607 |
| License Number State | CA |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 036108714 |
| License Number State | IL |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | 036108714 |
| License Number State | IL |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 202K00000X |
| Taxonomy | Phlebology Physician |
| License Number | G87607 |
| License Number State | CA |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 202K00000X |
| Taxonomy | Phlebology Physician |
| License Number | P9260 |
| License Number State | TX |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 202K00000X |
| Taxonomy | Phlebology Physician |
| License Number | 036108714 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: