Individual
DR. CHARLES BARRY GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
425 LOMBARD ST, THOUSAND OAKS, CA 91360-5898
(805) 495-2735
(805) 495-7406
Mailing address
425 LOMBARD ST, THOUSAND OAKS, CA 91360-5898
(805) 495-2735
(805) 495-7406
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC17158
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC0171580
BLUE SHIELD
CA
Enumeration date
01/08/2007
Last updated
07/09/2007
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