Individual
DR. LAURA FAY GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 364-4050
(714) 364-4051
Mailing address
1201 W LA VETA AVE, ORANGE, CA 92868-4203
(714) 364-4050
(714) 364-4051
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
A126862
CA
2086S0120X
Pediatric Surgery Physician
Primary
A126862
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/18/2012
Last updated
08/12/2021
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