Provider Demographics
NPI:1629017728
Name:GOO, HELEN A (MD)
Entity Type:Individual
Prefix:DR
First Name:HELEN
Middle Name:A
Last Name:GOO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:HELEN
Other - Middle Name:GOO
Other - Last Name:WELDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:26388 ANTONIO CIR
Mailing Address - Street 2:
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-6723
Mailing Address - Country:US
Mailing Address - Phone:909-496-7313
Mailing Address - Fax:
Practice Address - Street 1:10800 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92505-3043
Practice Address - Country:US
Practice Address - Phone:866-984-7483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA861260207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A861260Medicaid
CAI22324Medicare UPIN