Individual provider Active NPI

Ellen Havah Goldstein, M.D.

  • Reproductive Endocrinology Physician
  • Los Angeles, CA
National Provider Identifier
1447578604
Registry record updated Oct 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
A125501 Issued in CA
Practice address
10390 Santa Monica Blvd Ste 340
Los Angeles, CA 90025-6915
Phone
(310) 855-3688
Fax
(310) 855-3390
NPI assigned
May 12, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Reproductive Endocrinology Physician 207VE0102X A125501 CA Primary

Addresses

Primary practice location

10390 Santa Monica Blvd Ste 340
Los Angeles, CA 90025-6915

Mailing address

10390 Santa Monica Blvd Ste 340
Los Angeles, CA 90025-6915
Phone (310) 855-3688

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140317001167 CA Practitioner - Obstetrics/Gynecology 0345471314 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A125501CAMDReproductive Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles Auditor Controller CurrentSince Feb 1, 2014 Accepting new patients
Dr. Ellen Goldstein Inc. Reproductive Endocrinology CurrentSince Oct 16, 2022 Accepting new patients
Tri-County Surgery Center, Inc. CurrentSince Oct 16, 2022 Accepting new patients
County of Los Angeles Current Accepting new patients
County of Los Angeles CurrentSince Feb 1, 2014 Accepting new patients

Locations

10390 Santa Monica Blvd
Ste 340
Los Angeles, CA 90025
Phone (310) 855-3688

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1273622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1447578604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10390 SANTA MONICA BLVD STE 340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256915",
            "telephone_number": "310-855-3688",
            "fax_number": "310-371-4273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10390 SANTA MONICA BLVD STE 340",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900256915",
            "telephone_number": "310-855-3688",
            "fax_number": "310-855-3390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "ELLEN",
        "middle_name": "HAVAH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "CA",
            "license": "A125501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.