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General NPI Number Information
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NPI Number | 1134289978
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Entity Type | Organization
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Legal Business Name | HGL CORPORATION
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 11045 N 19TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85029-4816
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Country | US
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Telephone | 602-944-4474
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Fax | 602-944-0194
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Provider Business Mailing Address
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Address Line | 11045 N 19TH AVE
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City | PHOENIX
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State | AZ
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Zip | 85029-4816
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Country | US
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Telephone | 602-944-4474
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Fax | 602-944-0194
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. HERBERT D GOODMAN
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Credential | M.D.
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Telephone | 602-944-4474
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2014
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 2800
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7607
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License Number State | AZ
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