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General NPI Number Information
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NPI Number | 1093154825
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Entity Type | Individual
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Provider Name | STEVEN GODELMAN MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 4500 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-4090
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Country | US
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Telephone | 951-788-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 22 EBB TIDE CIR
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-2842
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Country | US
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Telephone | 818-606-5495
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Fax |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MT204735
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | ME152582
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 2086S0127X
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Taxonomy Name | Trauma Surgery Physician
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License Number | 163683
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License Number State | CA
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