Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | A80676 | CA |
NPI | 1376707711 |
---|---|
Provider Name | Mytien Goldberg |
First Address | Torrance, CA 90503 |
Second Address | Torrance, CA 90503-3808 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2008 |
Last Update Date | 07/06/2010 |