MEDICARE: DR. MICHAEL 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	207Q00000X	Family Medicine Physician	148213	NY
2	207Q00000X	Family Medicine Physician	C167572	CA

General Provider Information

NPI Number	:	1821150657
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL GOLDBERG M.D.

Provider Business Mailing Address
First Line	:	1860 HOWE AVE STE 440
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95825-1098
Country	:	US
Telephone Number	:	916-569-8484
Fax Number	:

Provider Business Practice Location Address
First Line	:	5385 FRANKLIN BLVD STE K
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95820-4717
Country	:	US
Telephone Number	:	916-454-2345
Fax Number	:	916-457-2667

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

Provider Enumeration Date	:	12/15/2006
Last Update Date	:	06/03/2022

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