Provider Demographics
NPI:1588605653
Name:GOH, MARIE U (PA)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:U
Last Name:GOH
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:45 CASTRO ST
Mailing Address - Street 2:MEDICAL OFFICE BUILDING #410
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94114-1010
Mailing Address - Country:US
Mailing Address - Phone:415-565-6884
Mailing Address - Fax:415-600-6886
Practice Address - Street 1:45 CASTRO ST
Practice Address - Street 2:MEDICAL OFFICE BUILDING #410
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94114-1010
Practice Address - Country:US
Practice Address - Phone:415-565-6884
Practice Address - Fax:415-600-6886
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2023-01-19
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Provider Licenses
StateLicense IDTaxonomies
CAPA 18359363A00000X
CAPA18359363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G786031Medicare PIN
CA00G786030Medicare PIN