Basic Information
Provider Information
NPI: 1629126289
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GOEI
FirstName: RAYMOND
MiddleName: H.I.
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9960 BALDWIN PL
Address2:  
City: EL MONTE
State: CA
PostalCode: 917312204
CountryCode: US
TelephoneNumber: 6267742988
FaxNumber:  
Practice Location
Address1: 9960 BALDWIN PL
Address2:  
City: EL MONTE
State: CA
PostalCode: 917312204
CountryCode: US
TelephoneNumber: 6267742988
FaxNumber:  
Other Information
ProviderEnumerationDate: 01/08/2007
LastUpdateDate: 09/06/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X20A6848CAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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