Provider Demographics
NPI:1952036675
Name:DR. ADAM D. GOLDSTONE, O.D., INC.
Entity Type:Organization
Organization Name:DR. ADAM D. GOLDSTONE, O.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:D
Authorized Official - Last Name:GOLDSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:661-942-7007
Mailing Address - Street 1:44665 VALLEY CENTRAL WAY
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-6500
Mailing Address - Country:US
Mailing Address - Phone:661-942-7007
Mailing Address - Fax:661-942-7009
Practice Address - Street 1:44665 VALLEY CENTRAL WAY
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-6500
Practice Address - Country:US
Practice Address - Phone:661-942-7007
Practice Address - Fax:661-942-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization