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General NPI Number Information
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NPI Number | 1942413869
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Entity Type | Individual
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Provider Name | STEVEN FOSTER GOSSARD MD
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Gender | Male
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9100 WILSHIRE BLVD EAST PENTHOUSE
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3401
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Country | US
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Telephone | 310-288-9999
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Fax |
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Provider Business Mailing Address
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Address Line | 8800 WENTWORTH ST
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City | SUNLAND
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State | CA
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Zip | 91040-2334
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Country | US
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Telephone | 818-353-0686
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | G37361
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License Number State | CA
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