Provider Demographics
NPI:1093021065
Name:GOLDSCHMIDT, ELISABETH (LAC)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:GOLDSCHMIDT
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 OAK ST
Mailing Address - Street 2:#11
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2232
Mailing Address - Country:US
Mailing Address - Phone:415-652-9042
Mailing Address - Fax:
Practice Address - Street 1:491A GUERRERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1020
Practice Address - Country:US
Practice Address - Phone:415-595-2083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2013-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13624171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist