Healthcare Provider Details

I. General information

NPI: 1750478160
Provider Name (Legal Business Name): RESPIRATORY CONSULTANTS OF SANTA MONICA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 11/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 20TH ST SUITE 360
SANTA MONICA CA
90404-2050
US

IV. Provider business mailing address

1301 20TH ST SUITE 360
SANTA MONICA CA
90404-2050
US

V. Phone/Fax

Practice location:
  • Phone: 310-828-3465
  • Fax: 310-315-0339
Mailing address:
  • Phone: 310-828-3465
  • Fax: 310-315-0339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: ELLIOT L. GOLDMAN
Title or Position: PARTNER
Credential: M.D.
Phone: 310-828-3465