Provider Demographics
NPI:1447578604
Name:GOLDSTEIN, ELLEN HAVAH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:HAVAH
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10390 SANTA MONICA BLVD STE 340
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6915
Mailing Address - Country:US
Mailing Address - Phone:310-855-3688
Mailing Address - Fax:310-371-4273
Practice Address - Street 1:10390 SANTA MONICA BLVD STE 340
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6915
Practice Address - Country:US
Practice Address - Phone:310-855-3688
Practice Address - Fax:310-855-3390
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA125501207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology