| Mark P Goodman Md Inc | |
|
435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5027 | |
| (310) 271-6889 | |
| Not Available |
| Full Name | Mark P Goodman Md Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 435 N Roxbury Dr, Beverly Hills, California |
| Authorized Official Name and Position | Mark Goodman (PRESIDENT) |
| Authorized Official Contact | 3102716889 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark P Goodman Md Inc 435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5027 Ph: (310) 271-6889 | Mark P Goodman Md Inc 435 N Roxbury Dr Ste 300 Beverly Hills CA 90210-5027 Ph: (310) 271-6889 |
| NPI Number | 1346652856 |
|---|---|
| Provider Enumeration Date | 06/02/2014 |
| Last Update Date | 06/02/2014 |
| Medicare PECOS PAC ID | 5597982504 |
|---|---|
| Medicare Enrollment ID | O20140815000763 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346652856 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | G81205 (California) | Primary |
| Provider Name | Mark P Goodman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477659407 PECOS PAC ID: 7113173873 Enrollment ID: I20120813000099 |
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