Basic Information
| Provider Information | |||||||||
| NPI: | 1619912961 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAVAL | ||||||||
| FirstName: | NIKHILKUMAR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2307 AVENUE N | ||||||||
| Address2: | |||||||||
| City: | NEDERLAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 776276266 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4096264737 | ||||||||
| FaxNumber: | 7609407770 | ||||||||
| Practice Location | |||||||||
| Address1: | TRI-CITY MEDICAL CENTER | ||||||||
| Address2: | 4002 VISTA WAY | ||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 92056 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4098426330 | ||||||||
| FaxNumber: | 4098429330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2006 | ||||||||
| LastUpdateDate: | 12/19/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080N0001X | A62818 | CA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine | 2080N0001X | K7087 | TX | N | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
No ID Information.