Individual provider Active NPI

Michael G Goldstein, M.D.

  • General Practice Physician
  • Los Angeles, CA
National Provider Identifier
1669683082
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G20440 Issued in CA
Practice address
3350 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1825
Phone
(213) 385-4607
Fax
(213) 385-4322
NPI assigned
May 25, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G20440 CA Primary

Addresses

Primary practice location

3350 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1825

Mailing address

3350 Wilshire Blvd Ste 120
Los Angeles, CA 90010-1825
Phone (213) 385-4607

Other identifiers 1

IdentifierTypeStateIssuer
G20440OtherCAMEDICAL CERTIFICATE

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G20440CAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Michael G Goldstein MD Inc General Practice PastSince Sep 5, 2007 Accepting new patients

Organizations & group practices 1

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": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669683082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3350 WILSHIRE BLVD STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101825",
            "telephone_number": "213-385-4607",
            "fax_number": "213-385-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 WILSHIRE BLVD STE 120",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900101825",
            "telephone_number": "213-385-4607",
            "fax_number": "213-385-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDSTEIN",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G20440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL CERTIFICATE",
            "identifier": "G20440",
            "state": "CA"
        }
    ],
    "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 Jul 8, 2007; 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.