Organization
LAWRENCE T. GOODWIN, JR., M.D., INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VERONICA CARRILLO (OFFICE MANAGER)
(310) 674-2895
Entity
Organization
Contact information
Practice address
8717 LA TIJERA BLVD, LOS ANGELES, CA 90045-3906
(310) 645-4393
(310) 645-3344
Mailing address
8717 LA TIJERA BLVD, LOS ANGELES, CA 90045-3906
(310) 645-4393
(310) 645-3344
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C40581
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C405811
—
CA
Enumeration date
01/15/2008
Last updated
07/22/2009
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