MEDICARE: DR. TROY DAVID GOLDBERG M.D.

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	2084P0800X	Psychiatry Physician	A80375	CA
2	2084P0804X	Child & Adolescent Psychiatry Physician	A80375	CA

General Provider Information

NPI Number	:	1689893042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TROY DAVID GOLDBERG M.D.

Provider Business Mailing Address
First Line	:	13636 VENTURA BLVD # 281
Second Line	:
City	:	SHERMAN OAKS
State	:	CA
Zip	:	91423-3700
Country	:	US
Telephone Number	:	818-256-6700
Fax Number	:	818-725-1560

Provider Business Practice Location Address
First Line	:	16055 VENTURA BLVD STE 645
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2609
Country	:	US
Telephone Number	:	818-256-6700
Fax Number	:	818-725-1560

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	03/13/2024

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