MEDICARE: DR. ANITA GOLDSTEIN DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NN1001X	Nutrition Chiropractor	DC29526	CA

General Provider Information

NPI Number	:	1417924259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANITA GOLDSTEIN DC

Provider Business Mailing Address
First Line	:	3121 ROBERTS AVE
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-7414
Country	:	US
Telephone Number	:	310-567-7977
Fax Number	:

Provider Business Practice Location Address
First Line	:	3121 ROBERTS AVE
Second Line	:
City	:	CULVER CITY
State	:	CA
Zip	:	90232-7414
Country	:	US
Telephone Number	:	310-567-7977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/01/2006
Last Update Date	:	09/11/2020

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