MEDICARE: DR. RAHUL SOMANI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	G87607	CA
2	2085R0204X	Vascular & Interventional Radiology Physician	P9260	TX
3	2085R0202X	Diagnostic Radiology Physician	P9260	TX
4	2085R0204X	Vascular & Interventional Radiology Physician	G87607	CA
5	2085R0202X	Diagnostic Radiology Physician	036108714	IL
6	2085R0204X	Vascular & Interventional Radiology Physician	036108714	IL
7	202K00000X	Phlebology Physician	G87607	CA
8	202K00000X	Phlebology Physician	P9260	TX
9	202K00000X	Phlebology Physician	036108714	IL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	351855YMZS	OTHER	TX	MEDICARE INDIVIDUAL PTAN
2	351855YSWX	OTHER	TX	MEDICARE INDIVIDUAL PTAN
3	P01362568	OTHER	TX	MEDICARE RAILROAD PTAN

General Provider Information

NPI Number	:	1033180203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAHUL SOMANI M.D.

Provider Business Mailing Address
First Line	:	5424 HEATHERLAND DR
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94582-5054
Country	:	US
Telephone Number	:	925-786-1402
Fax Number	:	925-968-1323

Provider Business Practice Location Address
First Line	:	5424 HEATHERLAND DR
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94582-5054
Country	:	US
Telephone Number	:	925-786-1402
Fax Number	:	925-968-1323

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/27/2006
Last Update Date	:	02/17/2016

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