Healthcare Provider Details

I. General information

NPI: 1831307438
Provider Name (Legal Business Name): VISHAL RANA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 01/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4110 BRIARGATE PKWY STE 460
COLORADO SPRINGS CO
80920-7839
US

IV. Provider business mailing address

8890 N UNION BLVD STE 160
COLORADO SPRINGS CO
80920-7799
US

V. Phone/Fax

Practice location:
  • Phone: 719-365-6568
  • Fax: 719-365-6317
Mailing address:
  • Phone: 719-365-9950
  • Fax: 719-365-9969

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number54565
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMT198198
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberDR-52914
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: