Provider Demographics
NPI:1821166513
Name:GOLDSAND, RICHARD STEVEN (GCFP)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:STEVEN
Last Name:GOLDSAND
Suffix:
Gender:M
Credentials:GCFP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11675 N 101ST ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-6054
Mailing Address - Country:US
Mailing Address - Phone:602-803-2410
Mailing Address - Fax:480-860-6524
Practice Address - Street 1:11675 N 101ST ST
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6054
Practice Address - Country:US
Practice Address - Phone:602-803-2410
Practice Address - Fax:480-860-6524
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other