Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | G43192 | CA |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | G43192 | CA |
NPI | 1699796045 |
---|---|
Provider Name | James D Goldberg |
First Address | San Francisco, CA 94109-5455 |
Second Address | San Francisco, CA 94109-5455 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 20/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G431920 | (05) | CA |
A49265 | (02) | CA |