Healthcare Provider Details

I. General information

NPI: 1649201823
Provider Name (Legal Business Name): KRISHAN K GOEL MD INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/05/2006
Last Update Date: 06/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 DELBON AVE
TURLOCK CA
95382-2021
US

IV. Provider business mailing address

1100 DELBON AVE
TURLOCK CA
95382-2021
US

V. Phone/Fax

Practice location:
  • Phone: 209-667-0905
  • Fax: 209-667-0922
Mailing address:
  • Phone: 209-667-0905
  • Fax: 209-667-0922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISHAN GOEL
Title or Position: PRESIDENT
Credential: MD
Phone: 209-667-0905