Healthcare Provider Details

I. General information

NPI: 1649371915
Provider Name (Legal Business Name): SANTOSH GOPAL RANE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9950 W CHEYENNE AVE STE 110
LAS VEGAS NV
89129-7700
US

IV. Provider business mailing address

PO BOX 98978
LAS VEGAS NV
89193-8978
US

V. Phone/Fax

Practice location:
  • Phone: 702-805-5678
  • Fax: 702-268-7605
Mailing address:
  • Phone: 702-216-3346
  • Fax: 702-671-6883

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD60476157
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number17265
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101240621
License Number StateVA
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number17265
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: