Provider Demographics
NPI:1649381641
Name:GOLDSTONE, ALAN MANUEL (OD)
Entity type:Individual
Prefix:DR
First Name:ALAN
Middle Name:MANUEL
Last Name:GOLDSTONE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2280 E CARSON ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3044
Mailing Address - Country:US
Mailing Address - Phone:562-422-2020
Mailing Address - Fax:562-426-2214
Practice Address - Street 1:2280 E CARSON ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3044
Practice Address - Country:US
Practice Address - Phone:562-422-2020
Practice Address - Fax:562-426-2214
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12297T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWY185Medicare UPIN