Provider Demographics
NPI:1093053175
Name:MARTIN L. GOLDMAN, DDS
Entity Type:Organization
Organization Name:MARTIN L. GOLDMAN, DDS
Other - Org Name:SOLANO SLEEP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-527-6673
Mailing Address - Street 1:900 COLUSA AVE
Mailing Address - Street 2:SUITE 205-A
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2319
Mailing Address - Country:US
Mailing Address - Phone:510-527-6673
Mailing Address - Fax:510-868-6211
Practice Address - Street 1:900 COLUSA AVE
Practice Address - Street 2:SUITE 205-A
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2319
Practice Address - Country:US
Practice Address - Phone:510-527-6673
Practice Address - Fax:510-868-6211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58434332BC3200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment