Provider Demographics
NPI:1629161328
Name:GOLDSTINE, HOWARD ROGER (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:ROGER
Last Name:GOLDSTINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1250 LA VENTA DRIVE
Mailing Address - Street 2:#103
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361
Mailing Address - Country:US
Mailing Address - Phone:805-495-0841
Mailing Address - Fax:805-497-6912
Practice Address - Street 1:1250 LA VENTA DRIVE
Practice Address - Street 2:#103
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361
Practice Address - Country:US
Practice Address - Phone:805-495-0841
Practice Address - Fax:805-497-6912
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG22874208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics