Individual
JOHN ETHAN GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4610 X ST, SACRAMENTO, CA 95817-2200
(916) 816-0478
Mailing address
2215 ROSE ST, BERKELEY, CA 94709-1430
(424) 366-3794
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A149423
CA
208000000X
Pediatrics Physician
M-17073
ID
208M00000X
Hospitalist Physician
A149423
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/06/2014
Last updated
03/08/2023
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