Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 103000 | CA |
NPI | 1003394511 |
---|---|
Provider Name | Rahul Deepak Golani |
First Address | Bakersfield, CA 93309-7081 |
Second Address | Fresno, CA 93726-0973 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/08/2018 |
Last Update Date | 06/08/2018 |