GLENN I. GOLDBERG, D.O., A PROFESSIONAL MEDICAL CORPORATION (NPI# 1205051083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205051083 |
| Entity Type | Organization |
| Organization Name | GLENN I. GOLDBERG, D.O., A PROFESSIONAL MEDICAL CORPORATION |
| Practice Address |
31852 Coast Hwy Suite 300 Laguna Beach CA 92651-6764 |
| Practice Telephone | 9494991389 |
| Practice Fax Number | 9494995689 |
| Mailing Telephone | 9494991389 |
| Mailing Fax Number | 4944995689 |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GLENN I GOLDBERG (OWNER) |
| Authorized Official Telephone | 9494991389 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 20A5649 | CA | Other Service Providers |
| Street Address |
31852 COAST HWY SUITE 300 |
| City | LAGUNA BEACH |
| State | CA |
| Zip Code | 92651-6764 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083610703 | Jagadeesh C Reddy | Internal Medicine | 31852 Coast Hwy, Ste 201, Laguna Beach, CA 92651-6765 | 2005-06-27 |
| 1396082202 | Phon H Vuong | Physician Assistant | 31852 Coast Hwy, Suite 300, Laguna Beach, CA 92651-6764 | 2013-01-11 |
| 1457602757 | Gabor Kovacs Md A Medical Corporation | Internal Medicine | 31852 Coast Hwy, Ste 305, Laguna Beach, CA 92651-6764 | 2012-09-26 |
| 1083843445 | Shin Min Li | Acupuncturist | 31852 Coast Hwy, Ste 307, Laguna Beach, CA 92651-6764 | 2009-07-07 |
| 1639308000 | Lily Wang | Acupuncturist | 31852 Coast Hwy, Ste 307, Laguna Beach, CA 92651-6764 | 2009-07-07 |
| 1508092586 | Donna L Jones | Audiologist | 31852 Coast Hwy, 400, Laguna Beach, CA 92651-6764 | 2009-06-04 |
| 1346489010 | Executive Medical Diagnostics | Physiological Laboratory | 31852 Coast Hwy, Suite 201, Laguna Beach, CA 92651-6764 | 2009-02-19 |
| 1215180088 | Dewing Medicine Inc | Clinic/Center | 31852 Coast Hwy, Suite 301, Laguna Beach, CA 92651-6764 | 2008-10-24 |
| 1326211848 | C Hinchliffe Inc | Clinic/Center | 31852 Coast Hwy, 400, Laguna Beach, CA 92651-6764 | 2008-04-04 |
| 1265557920 | David Sabet Dpm, A Professional Corporation | Podiatrist | 31852 Coast Hwy, Suite 105, Laguna Beach, CA 92651-6764 | 2007-03-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043856073 | Ocean View Neuropsychiatry | Psychiatry & Neurology | 31862 Coast Highway Unit 302, Laguna Beach, CA 92651 | 2019-11-25 |
| 1871154526 | Jinyi Bae | Psychiatry & Neurology | 31872 Coast Highway, Behavioral Health Unit, Laguna Beach, CA 92651 | 2019-06-24 |
| 1790348209 | Karen Veseth | Pharmacist | 30842 South Pacific Coast Highway, Laguna Beach, CA 92651 | 2019-04-19 |
| 1629536602 | Briana Kim | Pharmacist | 30842 S Pacific Coast Highway, Laguna Beach, CA 92651 | 2019-03-08 |
| 1295246288 | Priscilla Newton | Marriage & Family Therapist | 1427 Catalina, Laguna Beach, CA 92651 | 2017-10-17 |
| 1659723609 | Kassie Claughton | Social Worker | 1986 S Coast Hwy, Suite 1600, Laguna Beach, CA 92651 | 2016-07-01 |
| 1285029629 | Kathleen Susan Wenger | Counselor | 1550 South Pacific Coast Highway, #205, Laguna Beach, CA 92651 | 2015-04-02 |
| 1316350044 | Marcus D Yetter | Podiatrist | 31852 Coast Hwy Ste 105, Laguna Beach, CA 92651 | 2014-06-10 |
| 1891105854 | Connie Lee Bird | Social Worker | 332 Forest Ave #21, Laguna Beach, CA 92651 | 2014-04-30 |
| 1578989745 | Ana Maria Guerrero | Acupuncturist | 1100 South Coast Highway # 215, Laguna Beach, CA 92651 | 2014-03-12 |
| Find all providers in zip 92651 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851583777 | John Howard Wieland | Specialist | 1577 Skyline Dr, Laguna Beach, CA 92651-1944 | 2007-08-14 |
| 1710955919 | Leslie T Lochner | Specialist | 352 3rd St, Suite# 202, Laguna Beach, CA 92651-2357 | 2006-03-14 |
| 1609871888 | Steven N. Viele | Specialist | 31862 Coast Hwy, Ste 203, Laguna Beach, CA 92651-6771 | 2005-06-15 |
| 1649475146 | John S. Reynard, Jr., M.d., Inc. | Specialist | 31862 Coast Hwy, Ste 203, Laguna Beach, CA 92651-6769 | 2007-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113072 | Jonalyn Coronel | Specialist | 653 Canyon Rd, Novato, CA 94947-4331 | 2020-10-28 |
| 1497353239 | Nadia Nodoust-christensen | Specialist | 1627 Curtis Ave, Manhattan Beach, CA 90266-7022 | 2020-10-14 |
| 1073111936 | Griffin Nutrition Xterem | Specialist | 21575 Dome Trl, Topanga, CA 90290-3645 | 2020-10-13 |
| 1811503162 | George Thomas Lafortune | Specialist | 7927 Painter Ave Ste 200, Whittier, CA 90602-2480 | 2020-09-22 |
| 1699383661 | Transgender Health and Wellness Center | Specialist | 6700 Indiana Ave Ste 252, Riverside, CA 92506-4264 | 2020-07-16 |
| 1700403524 | Kelly Phillips | Specialist | 4650 Fruitvale Rd, Newcastle, CA 95658-9240 | 2020-06-27 |
| 1417572462 | Sarah Velez | Specialist | 1001 Potrero Ave Rm 7g19, San Francisco, CA 94110-3518 | 2020-06-15 |
| 1295350668 | Bette Graff | Specialist | 4148 10th St, Riverside, CA 92501-3110 | 2020-06-11 |
| 1114541463 | Serena Mink | Specialist | 100 Park Plz Apt 407, San Diego, CA 92101-6710 | 2020-06-02 |
| 1811510043 | Michael J Kodrich | Specialist | 40555 California Oaks Rd, Murrieta, CA 92562-5723 | 2020-05-21 |
| Find all providers with the same taxonomy | ||||
| City | LAGUNA BEACH |
| Zip Code | 92651 |
Please comment or provide details below to improve the information on GLENN I. GOLDBERG, D.O., A PROFESSIONAL MEDICAL CORPORATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.