Provider Demographics
NPI:1952426017
Name:GOLDSZTEIN, HERNAN (MD)
Entity Type:Individual
Prefix:
First Name:HERNAN
Middle Name:
Last Name:GOLDSZTEIN
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 1:530 LOMAS SANTA FE DR STE 1
Mailing Address - Street 2:
Mailing Address - City:SOLANA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92075-1350
Mailing Address - Country:US
Mailing Address - Phone:858-755-9343
Mailing Address - Fax:
Practice Address - Street 1:530 LOMAS SANTA FE DR STE 1
Practice Address - Street 2:
Practice Address - City:SOLANA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92075-1350
Practice Address - Country:US
Practice Address - Phone:858-755-9343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-20
Last Update Date:2015-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117595207YX0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFJ76ZMedicare PIN