Provider Demographics
NPI:1164432597
Name:GOEL, HITESH (MD)
Entity Type:Individual
Prefix:
First Name:HITESH
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 1:7391 W CHARLESTON BLVD
Mailing Address - Street 2:STE 140
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89117-1577
Mailing Address - Country:US
Mailing Address - Phone:702-304-2144
Mailing Address - Fax:702-304-2147
Practice Address - Street 1:7391 W CHARLESTON BLVD
Practice Address - Street 2:STE 140
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1577
Practice Address - Country:US
Practice Address - Phone:702-304-2144
Practice Address - Fax:702-304-2147
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10611207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV106808OtherSMACC MEDICARE
NVV105779Medicare PIN
NVV106808OtherSMACC MEDICARE
NVH98190Medicare UPIN
NVV106808OtherSMACC MEDICARE
NV100553Medicare ID - Type Unspecified
NV001513770Medicaid
NV100500484 GROUPMedicaid
NVWQBHVOtherWQBHV MEDICARE GROUP
NVV106647Medicare PIN