Ira Lee Goodman, MD

Primary specialty

Preventive Medicine/Occupational Environmental Medicine PhysicianTaxonomy code 2083P0500X

License

G40445 Issued in CA

Practice address

4316 Corte de la Fonda
San Diego, CA 92130-2126

Phone

(602) 741-3502

Fax

(888) 678-3543

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Valley Radiology Consultants Medical Group, Inc

  • Diagnostic Radiology Physician
  • Escondido, CA
  • NPI 1205897568
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1942321930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8390 E VIA DE VENTURA",
            "address_2": "SUITE F-110",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852583188",
            "telephone_number": "602-741-3502",
            "fax_number": "888-678-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 CORTE DE LA FONDA",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921302126",
            "telephone_number": "602-741-3502",
            "fax_number": "888-678-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODMAN",
        "first_name": "IRA",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "AZ",
            "license": "11747",
            "primary": false
        },
        {
            "code": "2083P0500X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine",
            "state": "CA",
            "license": "G40445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey A Goodman Eaton, LCSW
• Skye Goodman-Janow
• Ashley Allen Goodman, DDS
• Brock Aaron Goodman, D.D.S.
• Eric Todd Goodman, M.D.
• Jeffrey M. Goodman, MFT
• Jessica Goodman
• Krisztina Bodog Goodman, PSYD
• Kyana Goodman
• Nancy J. Goodman, MD

• Preventive Medicine/Occupational Environmental Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Preventive Medicine/Occupational Environmental Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.