Individual
THOMAS M GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1400 S GRAND AVE, STE 805, LOS ANGELES, CA 90015-3011
(213) 763-1500
(213) 763-1505
Mailing address
1640 MARENGO ST, STE 505, LOS ANGELES, CA 90033-1038
(323) 221-3270
(323) 225-6284
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
G65953
CA
207VX0000X
Obstetrics Physician
G65953
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G659530
BLUE SHIELD
CA
05
—
00G659530
—
CA
Enumeration date
06/15/2005
Last updated
08/22/2007
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