Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A161352 | CA |
NPI | 1013476811 |
---|---|
Provider Name | Dr. Jesse Ephraim Goldmacher |
First Address | Stanford, CA 94305-2296 |
Second Address | Stanford, CA 94305-2296 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2019 |
Last Update Date | 10/04/2019 |