Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | C25599 | CA |
N | 2080P0201X | Pediatric Allergist | C25599 | CA |
NPI | 1841378841 |
---|---|
Provider Name | Dr. Marshall G Goldberg |
First Address | Encino, CA 91316-2804 |
Second Address | Encino, CA 91316-2804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A87027 | (02) | CA |