Individual
ADVA GOLDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19353 VICTORY BLVD, TARZANA, CA 91335-6302
(818) 996-4742
Mailing address
19353 VICTORY BLVD, TARZANA, CA 91335-6302
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
81608
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18
PHARMACIST
CA
Enumeration date
12/10/2019
Last updated
10/08/2021
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