# GOODLIFE PHYSICAL MEDICINE CORP

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

## Provider details

- **NPI number:** 1891152781
- **Authorized official:** DR. ADAM WEITZMAN (OWNER)
- **Authorized official phone:** (310) 543-7779

## Contact information

- **Practice address:** 1300 S PACIFIC COAST HWY STE 201, REDONDO BEACH, CA 90277-5003
- **Practice address phone:** (310) 543-7779
- **Mailing address:** 1300 S PACIFIC COAST HWY STE 201, REDONDO BEACH, CA 90277-5003
- **Mailing address phone:** (310) 543-7779

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2016
- **Last updated:** 02/13/2018