Provider Demographics
NPI:1659339190
Name:GOLDSMITH, STEVEN PAUL (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:GOLDSMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130833
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92013-0833
Mailing Address - Country:US
Mailing Address - Phone:424-603-4876
Mailing Address - Fax:
Practice Address - Street 1:6620 AMBROSIA LN APT 410
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-2630
Practice Address - Country:US
Practice Address - Phone:424-603-4876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG195712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG19571OtherCALIFORNIA MEDICAL LICENSE
B98686Medicare UPIN