Update this page – If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS.
Organization
LIFESPAN THE CENTER FOR AGING AND REGENERATIVE MEDICINE
Active
Organization
LIFESPAN THE CENTER FOR AGING AND REGENERATIVE MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL GOODMAN MD (PRESIDENT)
(530) 605-4557
Entity
Organization
Contact information
Practice address
1465 VICTOR AVE, SUITE A, REDDING, CA 96003-4856
(530) 605-4557
(530) 605-4531
Mailing address
PO BOX 496084, REDDING, CA 96049-6084
(530) 605-4557
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G63650
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3502786
ARTICLES OF INC
CA
Enumeration date
11/01/2012
Last updated
12/03/2012
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up