Provider Demographics
NPI:1780061721
Name:PAVEL GOYKHMAN, M.D., APC
Entity type:Organization
Organization Name:PAVEL GOYKHMAN, M.D., APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GOYKHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-654-2020
Mailing Address - Street 1:948 N FAIRFAX AVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-7204
Mailing Address - Country:US
Mailing Address - Phone:323-654-2020
Mailing Address - Fax:
Practice Address - Street 1:948 N FAIRFAX AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046-7204
Practice Address - Country:US
Practice Address - Phone:323-654-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-28
Last Update Date:2015-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty