Evan Goldstein, D.O., Inc., a Professional Corporation

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

20A 14799 Issued in CA

Legal business name

EVAN GOLDSTEIN, D.O., INC., A PROFESSIONAL CORPORATION

Doing business as

Bespoke Surgical

Practice address

9033 Wilshire Blvd Ste 200
Beverly Hills, CA 90211-1836

Phone

(212) 206-1501

Fax

(888) 880-8621

NPI assigned

Sep 2, 2016

Organization subpart

No

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

Authorized official

Name

Evan Goldstein

Title

President

Phone

(212) 206-1501

Specialties & licenses 1

Addresses

Other names 1

• BESPOKE SURGICAL Doing business as

Locations

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

{
    "created_epoch": "1472774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1780131011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9033 WILSHIRE BLVD STE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111836",
            "telephone_number": "212-206-1501",
            "fax_number": "888-880-8621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9033 WILSHIRE BLVD STE 200",
            "city": "BEVERLY HILLS",
            "state": "CA",
            "postal_code": "902111836",
            "telephone_number": "212-206-1501",
            "fax_number": "888-880-8621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN GOLDSTEIN, D.O., INC., A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-02",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "EVAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "212-206-1501"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "20A 14799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BESPOKE SURGICAL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Surgery Physician in Beverly Hills, CA
• Providers in Beverly Hills, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.