Individual
DR. IRA LEE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4316 CORTE DE LA FONDA, SAN DIEGO, CA 92130-2126
(602) 741-3502
(888) 678-3543
Mailing address
8390 E VIA DE VENTURA, SUITE F-110, SCOTTSDALE, AZ 85258-3188
(602) 741-3502
(888) 678-3543
Taxonomy
Speciality
Code
Description
License number
State
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
11747
AZ
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
Primary
G40445
CA
Other
Enumeration date
04/03/2007
Last updated
10/07/2015
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