Provider Demographics
NPI:1942413869
Name:GOSSARD, STEVEN FOSTER (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:FOSTER
Last Name:GOSSARD
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 1:8800 WENTWORTH ST
Mailing Address - Street 2:
Mailing Address - City:SUNLAND
Mailing Address - State:CA
Mailing Address - Zip Code:91040-2334
Mailing Address - Country:US
Mailing Address - Phone:818-353-0686
Mailing Address - Fax:
Practice Address - Street 1:9100 WILSHIRE BLVD
Practice Address - Street 2:EAST PENTHOUSE
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3401
Practice Address - Country:US
Practice Address - Phone:310-288-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG37361174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist