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General NPI Number Information
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NPI Number | 1982742599
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Entity Type | Individual
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Provider Name | HOWARD GOLDBERG O.D.
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Gender | Male
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Dates
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Enumeration Date | 02/03/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2555 EL CAMINO REAL JC PENNEY OPTICAL
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City | CARLSBAD
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State | CA
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Zip | 92008-1202
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Country | US
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Telephone | 760-729-4188
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Fax | 760-729-8136
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Provider Business Mailing Address
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Address Line | 24916 LAGUNA VIS
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City | LAGUNA NIGUEL
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State | CA
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Zip | 92677-7471
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Country | US
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Telephone | 949-922-9116
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Fax | 949-606-8797
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 6235T
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License Number State | CA
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