Individual
DR. RETHA GOODGLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
(310) 453-1324
Mailing address
5767 W CENTURY BLVD # 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A111460
CA
208M00000X
Hospitalist Physician
Primary
A111460
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396994034
—
CA
Enumeration date
09/18/2008
Last updated
01/16/2024
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