NPIMap

Individual provider Active NPI

Kunal Om Goel

  • Internal Medicine Physician
  • Fort Bragg, CA
National Provider Identifier
1619610714
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A189299 Issued in CA
Practice address
700 River Dr
Fort Bragg, CA 95437-5403
Phone
(707) 961-4631
NPI assigned
Apr 16, 2022
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A189299 CA Primary

Addresses

Primary practice location

700 River Dr
Fort Bragg, CA 95437-5403

Mailing address

10790 Rancho Bernardo Rd # 4S-205
San Diego, CA 92127-5705
Phone (858) 554-3200

Other practice location 1

205 South St
Fort Bragg, CA 95437-5540
Phone (707) 964-1251

Other practice location 2

10666 N Torrey Pines Rd
LA Jolla, CA 92037-1027
Phone (858) 554-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250828003965 CA Practitioner - Internal Medicine 4183125420 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Duke University School of Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adventist Health Mendocino CoastGroup PAC ID 3678990769, 57 clinicians

Practice addresses (Care Compare)

700 River Dr
Fort Bragg, CA 95437-5403
Phone (707) 961-1234

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Adventist Health Mendocino Coast CurrentSince Oct 1, 2025 Accepting new patients
Ukiah Adventist Hospital CurrentSince Oct 1, 2025 Accepting new patients
Adventist Health Mendocino Coast CurrentSince Oct 1, 2025 Accepting new patients
Ukiah Adventist Hospital CurrentSince Oct 1, 2025 Accepting new patients

Locations

700 River Dr
Fort Bragg, CA 95437
Phone (707) 961-1234

1050 N State St
Ukiah, CA 95482
Phone (707) 463-7488

275 Hospital Dr
Ukiah, CA 95482
Phone (707) 462-7900

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/29a5ccea-f4ab-4447-a191-56b20695970f/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1619610714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10790 RANCHO BERNARDO RD # 4S-205",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921275705",
            "telephone_number": "858-554-3200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RIVER DR",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375403",
            "telephone_number": "707-961-4631"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "205 South St",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "CA",
            "postal_code": "954375540",
            "country_code": "US",
            "telephone_number": "707-964-1251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10666 N Torrey Pines Rd",
            "address_purpose": "LOCATION",
            "city": "LA Jolla",
            "state": "CA",
            "postal_code": "920371027",
            "country_code": "US",
            "telephone_number": "858-554-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOEL",
        "first_name": "KUNAL",
        "middle_name": "OM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-16",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A189299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

Verify at the official NPI Registry.