Individual
LEE RANDALL GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3955 E FORT LOWELL RD, SUITE 113, TUCSON, AZ 85712-1041
(520) 323-7277
(520) 881-1968
Mailing address
PO BOX 64086, TUCSON, AZ 85728-4086
(520) 323-7277
(320) 881-1968
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
31261
AZ
207RI0011X
Interventional Cardiology Physician
Primary
31261
AZ
207UN0901X
Nuclear Cardiology Physician
31261
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79077601
—
AZ
01
—
Z119329
PTAN
AZ
Enumeration date
07/18/2006
Last updated
01/20/2012
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