Individual
DR. GLENN I GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
31852 COAST HWY, SUITE 300, LAGUNA BEACH, CA 92651-6764
(949) 499-1389
(949) 499-5689
Mailing address
2285 CORPORATE CIR, STE 200, HENDERSON, NV 89074-7759
(702) 360-2763
(949) 783-2880
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
20A5649
CA
207ND0101X
MOHS-Micrographic Surgery Physician
20A5649
CA
207ND0900X
Dermatopathology Physician
20A5649
CA
207NS0135X
Procedural Dermatology Physician
20A5649
CA
Other
Enumeration date
11/29/2006
Last updated
02/18/2022
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