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General NPI Number Information
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NPI Number | 1669694857
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Entity Type | Individual
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Provider Name | BRIAN HALEVIE-GOLDMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 09/21/2015
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Provider Practice Location Address
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Address Line | 350 CHADBOURNE RD
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City | FAIRFIELD
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State | CA
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Zip | 94534-9636
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Country | US
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Telephone | 707-429-7181
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Fax | 707-429-8210
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Provider Business Mailing Address
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Address Line | 3000 CITRUS CIR 115
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2694
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Country | US
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Telephone | 925-478-8678
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Fax | 925-478-8677
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A38684
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License Number State | CA
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