MEDICARE: DR. STEVEN GOLBUS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G30783	CA

General Provider Information

NPI Number	:	1003336835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STEVEN GOLBUS MD

Provider Business Mailing Address
First Line	:	1457 EAST MADISON
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019
Country	:	US
Telephone Number	:	619-440-4591
Fax Number	:

Provider Business Practice Location Address
First Line	:	1457 E MADISON AVE
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92019-1002
Country	:	US
Telephone Number	:	619-440-4591
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2017
Last Update Date	:	06/22/2017

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