Provider Demographics
NPI:1689893042
Name:GOLDBERG, TROY DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:DAVID
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 1:13636 VENTURA BLVD # 281
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3700
Mailing Address - Country:US
Mailing Address - Phone:818-256-6700
Mailing Address - Fax:818-725-1560
Practice Address - Street 1:16055 VENTURA BLVD STE 645
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2609
Practice Address - Country:US
Practice Address - Phone:818-256-6700
Practice Address - Fax:818-725-1560
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA803752084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry