DR. GLENN I GOLDBERG (NPI# 1760559116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760559116 |
| Entity Type | Individual |
| Full Name | DR. GLENN I GOLDBERG |
| Credential | D.O. |
| 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 | 9494995689 |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207N00000X | Dermatology | 20A5649 | CA | Allopathic & Osteopathic Physicians |
| X | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
20A5649 | CA | Allopathic & Osteopathic Physicians |
| X | 207ND0900X |
Dermatology Specialization: Dermatopathology |
20A5649 | CA | Allopathic & Osteopathic Physicians |
| X | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
20A5649 | CA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093798936 | Glenn Marshall Goldberg | Psychologist | 9 St. Johns Medical Park Drive, St. Augustine, FL 32086 | 2005-11-23 |
| 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 |
| 1205051083 | Glenn I. Goldberg, D.o., A Professional Medical Corporation | Specialist | 31852 Coast Hwy, Suite 300, Laguna Beach, CA 92651-6764 | 2007-04-16 |
| 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 | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215584388 | Devon Malecki | Dermatology | 266 Canyon Acres Dr, Laguna Beach, CA 92651-1106 | 2019-08-22 |
| 1861823486 | William Pike | Dermatology | 2581 Iris Way, Laguna Beach, CA 92651-4014 | 2013-12-07 |
| 1700091113 | Danielle K Moul | Dermatology | 303 Broadway St Ste 104 Pmb 135, Laguna Beach, CA 92651 | 2007-05-11 |
| 1174728513 | Dermatology Associates of Orange County, Inc | Dermatology | 31862 Coast Hwy, Suite 201, Laguna Beach, CA 92651-6769 | 2007-06-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275144024 | Lumins Aesthetic and Wellness, Inc | Dermatology | 20281 Sw Birch St, Suite 201, Newport Beach, CA 92660 | 2020-08-14 |
| 1669081204 | Lucy Boyadzhian | Dermatology | 7472 Melrose Ave, Los Angeles, CA 90046-7524 | 2020-07-29 |
| 1033730981 | Adrianna Janell Browne, Md, Inc. | Dermatology | 8 Camino Encinas Ste 115, Orinda, CA 94563-3350 | 2020-05-01 |
| 1215564877 | Jasmine Khachatrian | Dermatology | 302 Sierra Woods Dr, Sierra Madre, CA 91024-1015 | 2020-03-24 |
| 1386277499 | Jessica Hsu, M.d.,inc | Dermatology | 1506 Chapman Avenue, Address Line 2, Orange, CA 92866 | 2020-02-17 |
| 1245862101 | Yuval Bibi, A Professional Corporation | Dermatology | 7266 Franklin Ave Apt 321, Los Angeles, CA 90046-8324 | 2020-02-09 |
| 1457982001 | Modesty Joy Isaguirre | Dermatology | 140 S Grand Ave, Glendora, CA 91741-4259 | 2020-02-03 |
| 1790322063 | Mfc Dermatology | Dermatology | 3655 Lomita Blvd Ste 221, Torrance, CA 90505-1918 | 2019-12-05 |
| 1336784206 | Barbara Kinkle Pa Inc., A Physician Assistant Corporation | Dermatology | 24575 Hunt Ave, Corning, CA 96021-8607 | 2019-11-14 |
| 1497399141 | Dermatology Specialists Inc | Dermatology | 4765 Carmel Mountain Rd Ste 201, San Diego, CA 92130-6657 | 2019-11-05 |
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| City | LAGUNA BEACH |
| Zip Code | 92651 |
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| 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.