Individual
GLENN PAUL GOLTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4240 ARGUELLO ST, SAN DIEGO, CA 92103-1506
(619) 299-0440
Mailing address
4240 ARGUELLO ST, SAN DIEGO, CA 92103-1506
(619) 299-0440
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C35609
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C35609
MEDICAL BOARD OF CALIFORNIA
CA
Enumeration date
12/26/2017
Last updated
12/26/2017
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