Provider Demographics
NPI:1265629513
Name:GOODNO POWERS & HARRIS M DS
Entity Type:Organization
Organization Name:GOODNO POWERS & HARRIS M DS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:POWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-446-5231
Mailing Address - Street 1:622 W DUARTE RD STE 305
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91007-9281
Mailing Address - Country:US
Mailing Address - Phone:626-446-5231
Mailing Address - Fax:626-446-0598
Practice Address - Street 1:622 W DUARTE RD STE 305
Practice Address - Street 2:
Practice Address - City:ARCADIA
Practice Address - State:CA
Practice Address - Zip Code:91007-9281
Practice Address - Country:US
Practice Address - Phone:626-446-5231
Practice Address - Fax:626-446-0598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-01
Last Update Date:2015-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW1146Medicare PIN