Individual
DR. JONATHAN WADE GOLDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2020 SANTA MONICA BLVD, SUITE 600, SANTA MONICA, CA 90404-2023
(310) 633-8400
Mailing address
2020 SANTA MONICA BLVD, SUITE 600, SANTA MONICA, CA 90404-2023
(310) 633-8400
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A82786
CA
207RH0003X
Hematology & Oncology Physician
Primary
A82786
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1750593844
—
CA
01
—
A82786
CALIFORNIA STATE MEDICAL LICENSE
CA
Enumeration date
05/03/2007
Last updated
11/23/2011
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