Ellie JC Goldstein MD Inc

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

License

G30475 Issued in CA

Legal business name

ELLIE JC GOLDSTEIN MD INC

Practice address

2021 Santa Monica Blvd
740 E
Santa Monica, CA 90404-2208

Phone

(310) 315-1511

Fax

(310) 315-3662

NPI assigned

Apr 8, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Ellie JC Goldstein MD Inc, M.D.

Title

President

Phone

(310) 315-1511

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 1

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

• Ellie J.C. Goldstein, M.D.

  • Infectious Disease Physician
  • Santa Monica, CA
  • NPI 1891710976
  Medicare reassignment NPD

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523404800000",
    "number": "1730405267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "740 E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-315-1511",
            "fax_number": "310-315-3662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD",
            "address_2": "740 E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042208",
            "telephone_number": "310-315-1511",
            "fax_number": "310-315-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLIE JC GOLDSTEIN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-08",
        "last_updated": "2018-04-11",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN MD INC",
        "authorized_official_first_name": "ELLIE",
        "authorized_official_middle_name": "JC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-315-1511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G30475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eliot Siegel MD Inc
• Elisa Seidner Otr Inc.
• Elisabeth Finnerty, a Professional Corporation
• Christine Marie Elisabeth, PSY.D
• Fuad Fredric Elkhoury, M.D.
• Elliot D Felman MD
• Alex Elliott
• Edward Albert Elliott, MD
• Thomas Robert Elliott
• Jasmine C. Ellison, LCSW

• Infectious Disease Physician in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Infectious Disease Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.