Healthcare Provider Details

I. General information

NPI: 1407232358
Provider Name (Legal Business Name): EZEQUIEL DARIO GOLDSCHMIDT M.D, PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2015
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 SUPERIOR AVE STE 290
NEWPORT BEACH CA
92663-3664
US

IV. Provider business mailing address

510 SUPERIOR AVE STE 290
NEWPORT BEACH CA
92663-3664
US

V. Phone/Fax

Practice location:
  • Phone: 949-763-7188
  • Fax:
Mailing address:
  • Phone: 949-763-7188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberA171371
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: