Provider Demographics
NPI:1982669222
Name:GOLDBERG, ANDREW N (MD, MSCE)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:N
Last Name:GOLDBERG
Suffix:
Gender:M
Credentials:MD, MSCE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2233 POST STREET
Mailing Address - Street 2:3RD FLOOR BOX 1225
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-1225
Mailing Address - Country:US
Mailing Address - Phone:415-353-2086
Mailing Address - Fax:
Practice Address - Street 1:2380 SUTTER STREET
Practice Address - Street 2:3RD FLOOR
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0342
Practice Address - Country:US
Practice Address - Phone:415-353-2757
Practice Address - Fax:415-353-2603
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG85676207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G856760Medicaid
CA00G856760Medicaid
CAE56761Medicare UPIN