Provider Demographics
NPI:1669671335
Name:GOLDMAN EYE LTD
Entity type:Organization
Organization Name:GOLDMAN EYE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOLDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:602-276-2497
Mailing Address - Street 1:7024 S 38TH PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85042-6215
Mailing Address - Country:US
Mailing Address - Phone:602-276-2497
Mailing Address - Fax:602-276-8169
Practice Address - Street 1:7024 S 38TH PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-6215
Practice Address - Country:US
Practice Address - Phone:602-276-2497
Practice Address - Fax:602-276-8169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1425261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center