Basic Information
Provider Information
NPI: 1437546025
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GOEL
FirstName: KHUSHBOO
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4140 W 190TH ST
Address2:  
City: TORRANCE
State: CA
PostalCode: 905045513
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 8723 ALDEN DR
Address2:  
City: LOS ANGELES
State: CA
PostalCode: 900483692
CountryCode: US
TelephoneNumber: 3104238784
FaxNumber: 3104232665
Other Information
ProviderEnumerationDate: 04/21/2015
LastUpdateDate: 08/23/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
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AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/23/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RP1001XDR.0062557CON Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RP1001XA176840CAY Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
207RC0200XDR.0062557CON Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine

No ID Information.


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