Individual
I SCOTT GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
400 N MOUNTAIN AVENUE, STE 310, UPLAND, CA 91786
(909) 920-0876
(909) 982-0784
Mailing address
400 N MOUNTAIN AVENUE, STE 310, UPLAND, CA 91786
(909) 920-0876
(909) 982-0784
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
A42592
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
125762100
DEPARTMENT OF LABOR IDENTIFICATION
CA
01
—
200005004
MEDICARE RAILROAD PIN
CA
Enumeration date
09/13/2006
Last updated
02/08/2021
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