Organization
CARMEL VALLEY NEUROLOGY PC
Active
Organization
CARMEL VALLEY NEUROLOGY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD A GOLDBERG MD (OWNER)
(866) 393-9869
Entity
Organization
Contact information
Practice address
12264 EL CAMINO REAL STE 303, SAN DIEGO, CA 92130
(866) 393-9869
(866) 393-9868
Mailing address
3830 VALLEY CENTRE DR, STE 705 PMB 423, SAN DIEGO, CA 92130-3343
(866) 393-9869
(866) 393-9868
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB298480
MEDICARE GROUP PTAN
CA
01
—
DY3247
RR MEDICARE GROUP PTAN
CA
Enumeration date
05/08/2018
Last updated
07/16/2018
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