Provider Demographics
NPI:1033180203
Name:SOMANI, RAHUL (MD)
Entity Type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:
Last Name:SOMANI
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 1:5424 HEATHERLAND DR
Mailing Address - Street 2:
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94582-5054
Mailing Address - Country:US
Mailing Address - Phone:925-786-1402
Mailing Address - Fax:925-968-1323
Practice Address - Street 1:5424 HEATHERLAND DR
Practice Address - Street 2:
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94582-5054
Practice Address - Country:US
Practice Address - Phone:925-786-1402
Practice Address - Fax:925-968-1323
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-27
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG876072085R0202X, 2085R0204X, 202K00000X
TXP92602085R0204X, 2085R0202X, 202K00000X
IL0361087142085R0202X, 2085R0204X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX351855YMZSOtherMEDICARE INDIVIDUAL PTAN
TX351855YSWXOtherMEDICARE INDIVIDUAL PTAN
TXP01362568OtherMEDICARE RAILROAD PTAN
TX351855YMZSOtherMEDICARE INDIVIDUAL PTAN
F95128Medicare UPIN
TX351855YY2HMedicare PIN
00G876070Medicare PIN
TX351855YY2GMedicare PIN
TX351855YUAVMedicare PIN
CA00G876073Medicare PIN