Healthcare Provider Details

I. General information

NPI: 1063528321
Provider Name (Legal Business Name): ALAN B GOLDSOBEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 02/25/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 MOORPARK AVE
SAN JOSE CA
95117-1840
US

IV. Provider business mailing address

4050 MOORPARK AVE
SAN JOSE CA
95117-1840
US

V. Phone/Fax

Practice location:
  • Phone: 408-243-2700
  • Fax: 408-551-2394
Mailing address:
  • Phone: 408-243-2700
  • Fax: 408-551-2394

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberG39891
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: