Organization Active NPI

Goldbro MD PC

  • Family Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1619793742
Registry record updated Nov 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GOLDBRO MD PC
Practice address
8190 Hollywood Blvd
Los Angeles, CA 90069-1610
Phone
(323) 819-7332
NPI assigned
Nov 22, 2024
Last updated
Nov 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2024

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

Authorized official

Name
Dr. Robert Goldberg, MDNPI 1275995649
Title
Founder/Owner
Phone
(323) 819-7332

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

8190 Hollywood Blvd
Los Angeles, CA 90069-1610

Mailing address

8190 Hollywood Blvd
Los Angeles, CA 90069-1610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241205002660 CA Part B Supplier - Clinic/Group Practice 0244766822 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1732233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732233600000",
    "number": "1619793742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8190 HOLLYWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900691610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8190 HOLLYWOOD BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900691610",
            "telephone_number": "323-819-7332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDBRO MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-22",
        "last_updated": "2024-11-22",
        "certification_date": "2024-11-22",
        "status": "A",
        "authorized_official_last_name": "GOLDBERG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "FOUNDER/OWNER",
        "authorized_official_telephone_number": "323-819-7332",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2024; 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.