Individual provider Active NPI

George Ansbach Goldberg, M.D.

  • Internal Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1235475013
Registry record updated Dec 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
G17616 Issued in CA
Practice address
253 25TH St
Santa Monica, CA 90402-2519
Phone
(310) 395-8989
NPI assigned
Dec 23, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X G17616 CA Primary

Addresses

Primary practice location

253 25TH St
Santa Monica, CA 90402-2519

Mailing address

253 25TH St
Santa Monica, CA 90402-2519
Phone (310) 395-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G17616CAMDInternal Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1356220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356220800000",
    "number": "1235475013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 25TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022519",
            "telephone_number": "310-395-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "253 25TH ST",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904022519",
            "telephone_number": "310-395-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "GEORGE",
        "middle_name": "ANSBACH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-23",
        "last_updated": "2012-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G17616",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Dec 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.