Provider Demographics
NPI:1053323253
Name:GOLDSTEIN, ARTHUR I (MD)
Entity Type:Individual
Prefix:
First Name:ARTHUR
Middle Name:I
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 BODEGA BAY DR
Mailing Address - Street 2:
Mailing Address - City:CORONA DEL MAR
Mailing Address - State:CA
Mailing Address - Zip Code:92625-1003
Mailing Address - Country:US
Mailing Address - Phone:714-835-0101
Mailing Address - Fax:714-835-1133
Practice Address - Street 1:1140 W LA VETA AVE STE 560
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4214
Practice Address - Country:US
Practice Address - Phone:714-835-0101
Practice Address - Fax:714-835-1133
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG15683174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA39589Medicare UPIN