Healthcare Provider Details

I. General information

NPI: 1649487174
Provider Name (Legal Business Name): ANGELA GOLDSTEIN N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34213 PACIFIC COAST HWY SUITE G
DANA POINT CA
92629-2875
US

IV. Provider business mailing address

34213 PACIFIC COAST HWY SUITE G
DANA POINT CA
92629-2875
US

V. Phone/Fax

Practice location:
  • Phone: 949-493-7284
  • Fax:
Mailing address:
  • Phone: 949-493-7284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND-28
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: