Individual
CARL STEPHEN GOETZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6401 COYLE AVENUE, #315, CARMICHAEL, CA 95608
(916) 966-6444
(916) 966-9077
Mailing address
6401 COYLE AVENUE, #315, CARMICHAEL, CA 95608
(916) 966-6444
(916) 966-9077
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G32226
CA
207ND0900X
Dermatopathology Physician
G32226
CA
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
G32226
CA
207NP0225X
Pediatric Dermatology Physician
G32226
CA
207NS0135X
Procedural Dermatology Physician
G32226
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G322260
—
CA
01
—
00G322261
MEDICARE PTAN
CA
Enumeration date
07/03/2006
Last updated
03/06/2008
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