Individual
ANDREW WILLIAM GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2210 E ILLINOIS AVE STE 401, FRESNO, CA 93701-2184
(559) 320-0580
(559) 320-0582
Mailing address
2625 E DIVISADERO ST, FRESNO, CA 93721-1431
(559) 443-2682
(559) 443-2681
Taxonomy
Speciality
Code
Description
License number
State
2084P0015X
Psychosomatic Medicine Physician
C132659
CA
2084P0800X
Psychiatry Physician
Primary
C132659
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200355710
—
IN
Enumeration date
05/20/2006
Last updated
01/09/2020
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