Provider Demographics
NPI:1477626950
Name:GOLDBERG STRAZNICKA INC
Entity Type:Organization
Organization Name:GOLDBERG STRAZNICKA INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAELA
Authorized Official - Middle Name:
Authorized Official - Last Name:STRAZNICKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-296-1755
Mailing Address - Street 1:175 LENNON LN STE 100
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2466
Mailing Address - Country:US
Mailing Address - Phone:925-296-7155
Mailing Address - Fax:925-296-7174
Practice Address - Street 1:1515 YGNACIO VALLEY RD STE A
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3005
Practice Address - Country:US
Practice Address - Phone:925-296-7155
Practice Address - Fax:925-296-7174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA72635208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH65712Medicare UPIN
CA00A726351Medicare ID - Type Unspecified
CAZZZ30905ZMedicare PIN
CADC2218Medicare PIN