Individual
MADISON THERESE GOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8635 W 3RD ST STE 350W, LOS ANGELES, CA 90048-6112
(310) 358-9008
(310) 657-8711
Mailing address
8635 W 3RD ST STE 350W, LOS ANGELES, CA 90048-6112
(310) 358-9008
(310) 657-8711
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA60733
CA
Other
Enumeration date
02/09/2022
Last updated
02/09/2022
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