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Individual

DR. JEFFREY D GOSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
16311 VENTURA BLVD, STE 630, ENCINO, CA 91436-4318
(818) 995-3039
(818) 995-3368
Mailing address
16311 VENTURA BLVD, STE 630, ENCINO, CA 91436-4318
(818) 995-3039
(818) 995-3368

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2510
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000E25100
CA
01
W21713
MEDICARE PTAN
CA
Enumeration date
06/17/2005
Last updated
07/18/2008
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