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General NPI Number Information
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NPI Number | 1003093188
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Entity Type | Individual
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Provider Name | RUTH L. GOLDMAN O.D.
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 09/25/2021
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Provider Practice Location Address
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Address Line | 24100 EL TORO RD SUITE C
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City | LAGUNA WOODS
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State | CA
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Zip | 92637
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Country | US
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Telephone | 949-586-8980
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Fax | 949-586-0624
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Provider Business Mailing Address
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Address Line | 24100 EL TORO RD SUITE C
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City | LAGUNA WOODS
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State | CA
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Zip | 92637
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Country | US
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Telephone | 949-586-8980
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Fax | 949-586-0624
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8961TPL
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8961
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License Number State | CA
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