Provider Demographics
NPI:1265467641
Name:GOLUB, MICHAEL SAUL (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:SAUL
Last Name:GOLUB
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 1:17681 ARVIDA DR
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1303
Mailing Address - Country:US
Mailing Address - Phone:818-363-4871
Mailing Address - Fax:818-363-4871
Practice Address - Street 1:17681 ARVIDA DR
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-1303
Practice Address - Country:US
Practice Address - Phone:818-363-4871
Practice Address - Fax:818-363-4871
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2015-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG12813207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism