Individual
DR. CHARLES DAVID GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
18350 ROSCOE BLVD STE 706, NORTHRIDGE, CA 91325-5602
(818) 993-1614
(818) 993-1341
Mailing address
18350 ROSCOE BLVD STE 706, NORTHRIDGE, CA 91325-5602
(818) 993-1614
(818) 993-1341
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G58389
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G583891
PROVIDER NUMBER
CA
05
—
1265829
—
CA
Enumeration date
07/27/2006
Last updated
07/09/2007
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