Provider Demographics
NPI:1124034103
Name:GOLDIN, RICHARD H (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:H
Last Name:GOLDIN
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 1:23441 MADISON ST
Mailing Address - Street 2:SUITE #340
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4725
Mailing Address - Country:US
Mailing Address - Phone:310-373-0340
Mailing Address - Fax:310-373-7142
Practice Address - Street 1:23441 MADISON ST
Practice Address - Street 2:SUITE #340
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4725
Practice Address - Country:US
Practice Address - Phone:310-373-0340
Practice Address - Fax:310-373-7142
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAGA23022207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW6231AMedicare ID - Type Unspecified
A86622Medicare UPIN