Provider Demographics
NPI:1235382680
Name:ANDREW GOLDSTEIN PC
Entity Type:Organization
Organization Name:ANDREW GOLDSTEIN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:H
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-882-1920
Mailing Address - Street 1:8144 E CACTUS RD
Mailing Address - Street 2:SUITE 800
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-5266
Mailing Address - Country:US
Mailing Address - Phone:480-596-8525
Mailing Address - Fax:480-596-8522
Practice Address - Street 1:8144 E CACTUS RD
Practice Address - Street 2:SUITE 800
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-5266
Practice Address - Country:US
Practice Address - Phone:480-596-8525
Practice Address - Fax:480-596-8522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-29
Last Update Date:2008-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29641208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z6009OtherHEALTHNET OF ARIZONA
AZ636491Medicaid
AZAZ0727360OtherBC/BS OF ARIZONA
AZ636491Medicaid
AZZ72736Medicare PIN