Provider Demographics
NPI:1013476811
Name:GOLDMACHER, JESSE EPHRAIM (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSE
Middle Name:EPHRAIM
Last Name:GOLDMACHER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR RM H3589
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2296
Mailing Address - Country:US
Mailing Address - Phone:647-825-8726
Mailing Address - Fax:650-725-0009
Practice Address - Street 1:300 PASTEUR DR RM H3589
Practice Address - Street 2:
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2296
Practice Address - Country:US
Practice Address - Phone:647-825-8726
Practice Address - Fax:650-725-0009
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-19
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA161352207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology