# ELLIE JC GOLDSTEIN MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730405267
- **Authorized official:** DR. ELLIE JC GOLDSTEIN MD INC M.D. (PRESIDENT)
- **Authorized official phone:** (310) 315-1511

## Contact information

- **Practice address:** 2021 SANTA MONICA BLVD, 740 E, SANTA MONICA, CA 90404-2208
- **Practice address phone:** (310) 315-1511
- **Practice address fax:** (310) 315-3662
- **Mailing address:** 2021 SANTA MONICA BLVD, 740 E, SANTA MONICA, CA 90404-2208
- **Mailing address phone:** (310) 315-1511
- **Mailing address fax:** (310) 315-3662

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RI0200X | Infectious Disease Physician | G30475 | CA | Yes |

## Other

- **Enumeration date:** 04/08/2010
- **Last updated:** 04/11/2018