Active NPI
Mark S. Goh, M.D.
- Anesthesiology Physician
- Santa Monica, CA
National Provider Identifier
1104969138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- A78713
- Practice address
- 1328 22ND St
Santa Monica, CA 90404-2032 - Phone
- (310) 829-8202
- Fax
- (310) 829-8209
- NPI assigned
- Feb 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | A78713 | CA | Primary |
Addresses
Primary practice location
1328 22ND St
Santa Monica, CA 90404-2032
Mailing address
PO Box 60790
Pasadena, CA 91116-6790
Phone (626) 795-6596
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CU0573 | Other | RAILROAD MEDICARE GROUP | |
| P00469799 | Other | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A78713 | CA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| La Quality Care Anesthesia Consultants Inc | Anesthesiology | Current | Accepting new patients |
| Bayside Anesthesia Medical Group | Current | Accepting new patients |
Locations
1500 E Chevy Chase Dr
Ste 101
Glendale, CA 91206
Phone (818) 265-1581
5700 San Fernando Rd
Glendale, CA 91202
Phone (818) 637-7766
1328 22nd St
Santa Monica, CA 90404
Phone (310) 829-5511
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pain Medicine (Anesthesiology) Physician
- Santa Monica, CA
- NPI 1184668469
-
- Anesthesiology Physician
- Glendale, CA
- NPI 1427470053
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438905600000",
"number": "1104969138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 60790",
"city": "PASADENA",
"state": "CA",
"postal_code": "911166790",
"telephone_number": "626-795-6596",
"fax_number": "626-795-8247"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1328 22ND ST",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042032",
"telephone_number": "310-829-8202",
"fax_number": "310-829-8209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOH",
"first_name": "MARK",
"middle_name": "S.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-15",
"last_updated": "2015-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CA",
"license": "A78713",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE GROUP",
"identifier": "CU0573",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00469799",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.