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General NPI Number Information
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NPI Number | 1083894232
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Entity Type | Organization
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Legal Business Name | ADAM D. GOLDSTONE, O.D., A PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 01/12/2011
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Provider Practice Location Address
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Address Line | 18625 1/2 VENTURA BLVD
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City | TARZANA
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State | CA
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Zip | 91356-4177
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Country | US
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Telephone | 818-708-2010
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Fax | 818-708-2017
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Provider Business Mailing Address
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Address Line | 18625 1/2 VENTURA BLVD
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City | TARZANA
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State | CA
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Zip | 91356-4177
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Country | US
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Telephone | 818-708-2010
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Fax | 818-708-2017
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ADAM D GOLDSTONE
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Credential | O.D.
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Telephone | 818-708-2010
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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 | 11051
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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 |
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License Number State |
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