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General NPI Number Information
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NPI Number | 1518064641
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Entity Type | Individual
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Provider Name | ALYSSA A NASH GOELITZ M.D.
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Gender | Female
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 9850 GENESEE AVENUE SUITE 850
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-657-0267
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Fax | 858-657-9485
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Provider Business Mailing Address
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Address Line | 9850 GENESEE AVENUE SUITE 850
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City | LA JOLLA
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State | CA
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Zip | 92037
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Country | US
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Telephone | 858-657-0267
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Fax | 858-657-9485
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A97756
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License Number State | CA
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