Organization
MYTIEN GOLDBERG MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYTIEN THI GOLDBERG M.D. (PRESIDENT)
(310) 618-9922
Entity
Organization
Contact information
Practice address
2808 COLUMBIA ST, TORRANCE, CA 90503-3808
(310) 618-9922
(310) 933-0978
Mailing address
2808 COLUMBIA ST, TORRANCE, CA 90503-3808
(310) 618-9922
(310) 933-0978
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A80676
CA
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
A80676
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376707711
PERSONAL PROVIDER NPI NUMBER
CA
Enumeration date
10/13/2010
Last updated
10/13/2010
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