Provider Demographics
NPI:1558612770
Name:GOYAL, TRETA PUROHIT (MBBS,, MPH)
Entity Type:Individual
Prefix:DR
First Name:TRETA
Middle Name:PUROHIT
Last Name:GOYAL
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Gender:F
Credentials:MBBS,, MPH
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Mailing Address - Street 1:2331 MONTPELIER DR
Mailing Address - Street 2:STE B
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1673
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1595 SOQUEL DR
Practice Address - Street 2:SUITE 140
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95065-1719
Practice Address - Country:US
Practice Address - Phone:831-462-4444
Practice Address - Fax:831-462-4488
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-27
Last Update Date:2017-05-08
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA138479207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program