Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | G32899 | CA |
NPI | 1033153424 |
---|---|
Provider Name | Dr. Stuart Louis Goldfarb |
First Address | Los Angeles, CA 90045-5631 |
Second Address | Los Angeles, CA 90095-3075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2006 |
Last Update Date | 08/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G328990 | (05) | CA |
A45336 | (02) | CA |