Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 8961 | CA |
N | 152W00000X | Optometrist | 8961TPL | CA |
NPI | 1003093188 |
---|---|
Provider Name | Dr. Ruth L. Goldman |
First Address | Laguna Woods, CA 92637 |
Second Address | Laguna Woods, CA 92637 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2008 |
Last Update Date | 25/09/2021 |