Individual
LAWRENCE M GOLDYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Mailing address
205 SOUTH ST, FORT BRAGG, CA 95437-5540
(707) 964-1251
(707) 961-2722
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
G67575
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FCH03967F
—
CA
Enumeration date
07/21/2006
Last updated
02/02/2011
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