Lifespan the Center for Aging and Regenerative Medicine

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G63650 Issued in CA

Legal business name

LIFESPAN THE CENTER FOR AGING AND REGENERATIVE MEDICINE

Practice address

1465 Victor Ave
Suite a
Redding, CA 96003-4856

Phone

(530) 605-4557

Fax

(530) 605-4531

NPI assigned

Nov 1, 2012

Organization subpart

No

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

Authorized official

Name

Daniel Goodman, MDNPI 1003987355

Title

President

Phone

(530) 605-4557

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Daniel M Goodman, MD

  • Anesthesiology Physician
  • Redding, CA
  • NPI 1003987355
  NPD (past) Authorized official

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

{
    "created_epoch": "1351728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354492800000",
    "number": "1447504147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 496084",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960496084",
            "telephone_number": "530-605-4557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 VICTOR AVE",
            "address_2": "SUITE A",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960034856",
            "telephone_number": "530-605-4557",
            "fax_number": "530-605-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESPAN THE CENTER FOR AGING AND REGENERATIVE MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-01",
        "last_updated": "2012-12-03",
        "status": "A",
        "authorized_official_last_name": "GOODMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-605-4557",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G63650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARTICLES OF INC",
            "identifier": "3502786",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandy Liebscher, PSYD
• Lien Family Pharmacy Corporation
• Andrew Van Lien
• Life Saving Devices Inc.
• Lifemed, Inc.
• Michelle Lim, PHARMD
• Limitless Healthcare, Inc
• Lims Family Pharmacy Inc
• Patricia Denise Lind, LCSW
• Hillary Lindauer, MA

• Anesthesiology Physician in Redding, CA
• Providers in Redding, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.