Doctor Name: | DR. ROBERT GOLDSTONE |
NPI Number: | 1174921555 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | A35186 |
Business Practice Address: | 227 Orchid Ave Corona Del Mar, CA - 926253013 |
Business Phone Number: | 9497062133 |
Business Fax Number: | |
Mailing Address: | 227 Orchid Ave, CORONA DEL MAR |
State: | CA |
Postal Code: | 926253013 |
Phone Number: | 9497062133 |
Fax Number: | |
NPI Enumeration Date: | 12/16/2014 |
NPI Last Update Date: | 12/16/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251V00000X |
License Number: | A35186 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Voluntary or Charitable |
Taxonomy Specialization: | |
Taxonomy Definition: |