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General NPI Number Information
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NPI Number | 1255396594
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Entity Type | Individual
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Provider Name | EDWARD J. GOETZL MD
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 400 PARNASSUS AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-2202
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Country | US
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Telephone | 415-353-2725
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Fax | 415-353-2568
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Provider Business Mailing Address
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Address Line | 1635 DIVISADERO STREET, SUITE 625, BOX 1821
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City | SAN FRANCISCO
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State | CA
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Zip | 94143-0001
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Country | US
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Telephone | 415-476-4029
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Fax | 415-476-4150
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | G47295
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RA0201X
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Taxonomy Name | Allergy & Immunology (Internal Medicine) Physician
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License Number | G47295
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | G47295
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License Number State | CA
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