MEDICARE: DR.HARVEY GOLDSTONE, A PROFESSIONAL CORPORATION

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	152W00000X	Optometrist	5273T	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316156037
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR.HARVEY GOLDSTONE, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	2280 E CARSON ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3044
Country	:	US
Telephone Number	:	562-422-2020
Fax Number	:	562-426-2214

Provider Business Practice Location Address
First Line	:	2280 E CARSON ST
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90807-3044
Country	:	US
Telephone Number	:	562-422-2020
Fax Number	:	562-426-2214

Authorized Official
Title or Position	:	PRESIDENT HEAD OF OPERATIONS DOCTOR
Name	:	DR. HARVEY ROY GOLDSTONE
Credential	:	O.D.
Telephone Number	:	562-422-2020

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	04/20/2009

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