Dimitry B. Goufman, MD, Inc.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

C52758 Issued in CA

Legal business name

DIMITRY B. GOUFMAN, MD, INC.

Practice address

705 W la Veta Ave Ste 115
Orange, CA 92868-4447

Phone

(714) 532-6201

Fax

(714) 532-6563

NPI assigned

Sep 17, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Dimitry B Goufman, MDNPI 1104824101

Title

Owner

Phone

(714) 532-6201

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dimitry B Goufman, M.D.

  • Otolaryngology Physician
  • Orange, CA
  • NPI 1104824101
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1189987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682985600000",
    "number": "1447446125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W LA VETA AVE STE 115",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684447",
            "telephone_number": "714-532-6201",
            "fax_number": "714-532-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W LA VETA AVE STE 115",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684447",
            "telephone_number": "714-532-6201",
            "fax_number": "714-532-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIMITRY B. GOUFMAN, MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-17",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A",
        "authorized_official_last_name": "GOUFMAN",
        "authorized_official_first_name": "DIMITRY",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "714-532-6201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "C52758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erika Chantelle Dillard
• Maureen M Dillon, LCSW
• Presli Drew Dillon
• Madelaine Janet Maceda Dimal
• Madison Dimino
• Dina Aleissa D.D.S. Inc.
• Andrew Ding
• Stephanie Ding
• Nikolas Dingcong
• Lisa Parducho Dinglasan, MSW, MPA, LCSW, ACM

• Otolaryngology Physician in Orange, CA
• Providers in Orange, CA by specialty
• Otolaryngology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.