Goodman, Gary
Goodman, Gary is an individual health care provider with primary practice located at 455 S Main St , Orange CA 92868-3835. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, which is considered as his primary health care specialty. Goodman, Gary can be contacted via phone (714) 532-8620.Contact Information
Primary practice address
455 S Main St
Orange CA 92868-3835
Phone: (714) 532-8620
Fax: (714) 289-4072
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine | 2080P0203X | G45219 | California |
Profile Details
| NPI number | 1588758551 |
|---|---|
| LBN Legal business name | Goodman, Gary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 3rd, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588758551 | NPPES |
| California | MEDICAID | 00G452190 |
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