Provider Demographics
NPI:1609171933
Name:GOLDBERG, LEONARD S (MD)
Entity Type:Individual
Prefix:
First Name:LEONARD
Middle Name:S
Last Name:GOLDBERG
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 1:3737 SAN DIMAS ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-5732
Mailing Address - Country:US
Mailing Address - Phone:661-327-5037
Mailing Address - Fax:661-327-7633
Practice Address - Street 1:3737 SAN DIMAS ST
Practice Address - Street 2:SUITE 101
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5732
Practice Address - Country:US
Practice Address - Phone:661-327-5037
Practice Address - Fax:661-327-7633
Is Sole Proprietor?:No
Enumeration Date:2011-01-18
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC26721207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology