Provider Demographics
NPI:1962679829
Name:GOYAL, VISHAL (MD)
Entity Type:Individual
Prefix:
First Name:VISHAL
Middle Name:
Last Name:GOYAL
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 1:2400 BATH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-4351
Mailing Address - Country:US
Mailing Address - Phone:805-682-7707
Mailing Address - Fax:805-682-7710
Practice Address - Street 1:2400 BATH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-4351
Practice Address - Country:US
Practice Address - Phone:805-682-7707
Practice Address - Fax:805-682-7710
Is Sole Proprietor?:No
Enumeration Date:2008-05-09
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA105207207RC0000X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP01227240OtherRAILROAD MEDICARE
CAP10227235OtherRAILROAD MEDICARE
CACL062XMedicare PIN
CAP01227240OtherRAILROAD MEDICARE