Healthcare Provider Details

I. General information

NPI: 1730172313
Provider Name (Legal Business Name): ROBYNN GOLDSTEIN N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 UCLA MEDICAL PLZ SUITE 770
LOS ANGELES CA
90024-6970
US

IV. Provider business mailing address

15243 VANOWEN ST SUITE 301
VAN NUYS CA
91405-3605
US

V. Phone/Fax

Practice location:
  • Phone: 310-824-3378
  • Fax: 310-208-2870
Mailing address:
  • Phone: 818-782-5041
  • Fax: 818-782-4864

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number15138
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: