Goodman, Mark
Goodman, Mark is an sole proprietor health care provider with primary practice located at 3200 Long Beach Blvd , Long Beach CA 90807-5062. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Goodman, Mark can be contacted via phone (562) 933-2000.Contact Information
Primary practice address
3200 Long Beach Blvd
Long Beach CA 90807-5062
Phone: (562) 933-2000
Fax: (562) 494-7792
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A31080 | California |
Profile Details
| NPI number | 1629005780 |
|---|---|
| LBN Legal business name | Goodman, Mark |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Oct 12th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629005780 | NPPES |
| California | MEDICAID | 00A310800 |
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