Provider Demographics
NPI:1033405592
Name:GOEL, ANURAG (MD)
Entity type:Individual
Prefix:
First Name:ANURAG
Middle Name:
Last Name:GOEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:651 N SEPULVEDA BLVD # 2012
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-2185
Mailing Address - Country:US
Mailing Address - Phone:858-386-2322
Mailing Address - Fax:
Practice Address - Street 1:1055 W HENDERSON AVE
Practice Address - Street 2:
Practice Address - City:PORTERVILLE
Practice Address - State:CA
Practice Address - Zip Code:93257-1490
Practice Address - Country:US
Practice Address - Phone:559-788-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2854992084P0800X
CAC1484422084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry