Provider Demographics
NPI:1972571636
Name:GOLDSTEIN, LAWRENCE J (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:J
Last Name:GOLDSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:GOLDSTEIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4 FINANCIAL PLZ
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-3043
Mailing Address - Country:US
Mailing Address - Phone:707-266-7051
Mailing Address - Fax:707-266-7052
Practice Address - Street 1:4 FINANCIAL PLZ
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-3043
Practice Address - Country:US
Practice Address - Phone:707-266-7051
Practice Address - Fax:707-266-7052
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2020-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2003-0639208600000X
CAG612532086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery