Provider Demographics
NPI:1629042254
Name:GOYAL, RAKESH KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:RAKESH
Middle Name:KUMAR
Last Name:GOYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 IRIS STREET
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94062-2050
Mailing Address - Country:US
Mailing Address - Phone:412-980-6737
Mailing Address - Fax:
Practice Address - Street 1:303 IRIS STREET
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94062-2050
Practice Address - Country:US
Practice Address - Phone:412-980-6737
Practice Address - Fax:816-302-9939
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC1676662080P0207X, 208000000X
KS04386712080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001726467Medicaid
PA001726467Medicaid
PAG94434Medicare UPIN