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General NPI Number Information
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NPI Number | 1649680117
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Entity Type | Organization
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Legal Business Name | GELSEY L GOODSTEIN MD INC
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 10/22/2015
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Provider Practice Location Address
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Address Line | 8700 BEVERLY BLVD
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City | WEST HOLLYWOOD
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State | CA
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Zip | 90048-1804
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Country | US
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Telephone | 323-656-1202
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1997
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City | BEVERLY HILLS
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State | CA
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Zip | 90213-1997
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Country | US
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Telephone | 323-656-1202
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | GELSEY L GOODSTEIN
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Credential | MD
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Telephone | 323-309-3859
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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 |
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License Number State |
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