1194114108 NPI number — CHHAVI GOYAL-MEHRA M.D.

Table of content: CHHAVI GOYAL-MEHRA M.D. (NPI 1194114108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194114108 NPI number — CHHAVI GOYAL-MEHRA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOYAL-MEHRA
Provider First Name:
CHHAVI
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194114108
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/14/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
TELERAD RXDX HEALTHCARE PVT LTD.PLOT NO7G
Provider Second Line Business Mailing Address:
OPPSITE GRAPHITE INDIA,WHITEFIELD
Provider Business Mailing Address City Name:
BANGALORE
Provider Business Mailing Address State Name:
KARNATAKA
Provider Business Mailing Address Postal Code:
560048
Provider Business Mailing Address Country Code:
IN
Provider Business Mailing Address Telephone Number:
918049261111
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
TELERAD RXDX HEALTHCARE
Provider Second Line Business Practice Location Address:
PLOT NO 7 G,OPPSITE GRAPHITE INDIA,WHITEFIELD
Provider Business Practice Location Address City Name:
BANGALORE
Provider Business Practice Location Address State Name:
KARNATAKA
Provider Business Practice Location Address Postal Code:
560048
Provider Business Practice Location Address Country Code:
IN
Provider Business Practice Location Address Telephone Number:
918049261111
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  54284 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)