Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 19981 | CA |
NPI | 1003183708 |
---|---|
Provider Name | Elisabeth Leslie Goldstein |
First Address | San Francisco, CA 94103-1519 |
Second Address | San Francisco, CA 94103-1519 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2011 |
Last Update Date | 27/10/2016 |