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General NPI Number Information
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NPI Number | 1275347437
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Entity Type | Organization
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Legal Business Name | ELLIOT L GOLDMAN MD A MEDICAL CORPORATION
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Dates
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Enumeration Date | 02/06/2025
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 11810 SATICOY ST
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City | NORTH HOLLYWOOD
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State | CA
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Zip | 91605-2848
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Country | US
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Telephone | 310-828-3465
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Fax | 310-315-0339
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Provider Business Mailing Address
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Address Line | PO BOX 7250
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City | SANTA MONICA
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State | CA
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Zip | 90406-7250
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Country | US
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Telephone | 310-828-3465
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Fax | 310-315-0339
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Authorized Official
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Title or Position | PRESIDENT
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Name | ELLIOT L GOLDMAN
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Credential | MD
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Telephone | 310-903-6847
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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