Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | G22766 | CA |
N | 2080P0210X | Pediatric Nephrologist | G22766 | CA |
NPI | 1497779722 |
---|---|
Provider Name | Dr. Barry Herschel Goldberg |
First Address | Oceanside, CA 92054-2328 |
Second Address | Oceanside, CA 92056-4509 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G227660 | (05) | CA |
A41713 | (02) | CA |