Goodman, Charles David

Goodman, Charles David is an sole proprietor health care provider with primary practice located at 18350 Roscoe Blvd Ste 706 , Northridge CA 91325-5602. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Goodman, Charles David can be contacted via phone (818) 993-1614.

Contact Information

Primary practice address
18350 Roscoe Blvd Ste 706 Northridge CA 91325-5602
Fax: (818) 993-1341
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X G58389 California

Profile Details

NPI number 1336163807
LBN Legal business name Goodman, Charles David
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2006
Last updated Jul 9th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336163807 NPPES
California Other 00G583891 PROVIDER NUMBER
California MEDICAID 1265829 PROVIDER NUMBER

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