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NPI Code Detail

MEDICARE: DR. ROBERT LEE GOODMAN MD

MEDICARE:  DR. ROBERT LEE GOODMAN  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
1207Q00000XFamily Medicine PhysicianA26203CA

General Provider Information

NPI Number : 1982666855
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBERT LEE GOODMAN MD
Provider Business Mailing Address
First Line : 1331 MEDICAL CENTER DR
Second Line : SUITE C
City : ROHNERT PARK
State : CA
Zip : 94928-2900
Country : US
Telephone Number : 707-584-7474
Fax Number : 707-584-7495
Provider Business Practice Location Address
First Line : 1331 MEDICAL CENTER DR
Second Line : SUITE C
City : ROHNERT PARK
State : CA
Zip : 94928-2900
Country : US
Telephone Number : 707-584-7474
Fax Number : 707-584-7495
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2006
Last Update Date : 01/31/2012

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Directions to “ DR. ROBERT LEE GOODMAN MD” Practice Location

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