Provider Demographics
NPI:1649371915
Name:RANE, SANTOSH GOPAL (MD)
Entity type:Individual
Prefix:DR
First Name:SANTOSH
Middle Name:GOPAL
Last Name:RANE
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:PO BOX 98978
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89193-8978
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:2911 N TENAYA WAY STE 104
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-0488
Practice Address - Country:US
Practice Address - Phone:702-805-5678
Practice Address - Fax:702-268-7605
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101240621207R00000X
NV17265207RC0000X, 207RC0001X
WAMD60476157207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVPENDINGOtherMEDICARE PIN
VA010324084Medicaid
VA010323941Medicaid
NV17265OtherNEVADA MEDICAL LICENSE
VA010324068Medicaid
NV1649371915Medicaid
VA011219C19Medicare PIN
011219C19Medicare PIN