Healthcare Provider Details
I. General information
NPI: 1962679829
Provider Name (Legal Business Name): VISHAL GOYAL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/09/2008
Last Update Date: 01/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2400 BATH ST SUITE 201
SANTA BARBARA CA
93105-4351
US
IV. Provider business mailing address
2400 BATH ST SUITE 201
SANTA BARBARA CA
93105-4351
US
V. Phone/Fax
- Phone: 805-682-7707
- Fax: 805-682-7710
- Phone: 805-682-7707
- Fax: 805-682-7710
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | A105207 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207UN0901X |
| Taxonomy | Nuclear Cardiology Physician |
| License Number | A105207 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: