LAWRENCE M GOLDYN (NPI# 1780605097) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780605097 |
| Entity Type | Individual |
| Full Name | LAWRENCE M GOLDYN |
| Credential | M.D. |
| Practice Address |
205 South St Fort Bragg CA 95437-5540 |
| Practice Telephone | 7079641251 |
| Practice Fax Number | 7079612722 |
| Mailing Telephone | 7079641251 |
| Mailing Fax Number | 7079612722 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2011-02-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
G67575 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FCH03967F | 05 |
| Street Address |
205 SOUTH ST |
| City | FORT BRAGG |
| State | CA |
| Zip Code | 95437-5540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508861782 | Wade Joseph Gray | Family Medicine | 205 South St, Fort Bragg, CA 95437-5540 | 2005-06-15 |
| 1477046027 | Roy Campbell | Dental Hygienist | 205 South St, Fort Bragg, CA 95437-5540 | 2018-06-08 |
| 1457861783 | Andrea Masters | Nurse Practitioner | 205 South St, Fort Bragg, CA 95437-5540 | 2017-09-29 |
| 1437501566 | Jae Do Kim | Dentist | 205 South St, Fort Bragg, CA 95437-5540 | 2016-07-13 |
| 1558790774 | Nadege Nerette | Physician Assistant | 205 South St, Fort Bragg, CA 95437-5540 | 2013-11-07 |
| 1932532272 | Svetlana Romanovna Mulcahy | Nurse Practitioner | 205 South St, Fort Bragg, CA 95437-5540 | 2013-08-09 |
| 1013257831 | Kimberly Jill Celeri | Dental Hygienist | 205 South St, Fort Bragg, CA 95437-5540 | 2013-02-15 |
| 1821340480 | Genevieve Marilyn Gonzalez | Counselor | 205 South St, Fort Bragg, CA 95437 | 2012-10-08 |
| 1447500988 | Ted Michael Aames | Counselor | 205 South St, Fort Bragg, CA 95437-5540 | 2012-09-12 |
| 1740587229 | Wendy J Carvajal | Dentist | 205 South St, Fort Bragg, CA 95437-5540 | 2011-02-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902357437 | Mendocino Coast Hospitality Center | Community/Behavioral Health | 137 E. Oak Street, Fort Bragg, CA 95437 | 2016-10-19 |
| 1144604570 | Erin Paul | Community Health Worker | 474 South Franklin Street, Fort Bragg, CA 95437 | 2015-07-15 |
| 1508125790 | Joel Macgregor Green | Marriage & Family Therapist | 331- G Redwood Ave., Fort Bragg, CA 95437 | 2012-05-09 |
| 1013244102 | Jenna Glasscock | Counselor | 331 E Redwood Ave, Ste E, Fort Bragg, CA 95437 | 2009-11-10 |
| 1770819641 | Patrick Lenaghan | Emergency Medicine | 707 River Dr, Fort Bragg, CA 95437 | 2009-10-27 |
| 1043455827 | M. Lee Baker | Dentist | 890 River Dr, Fort Bragg, CA 95437 | 2008-12-09 |
| 1528250495 | Christine Anne Samas | Social Worker | 656a Harrison St., Fort Bragg, CA 95437 | 2007-08-15 |
| 1083822811 | Katharine L. White | Marriage & Family Therapist | 137 E Oak Street, Fort Bragg, CA 95437 | 2007-05-17 |
| 1053525873 | Marty Christine Johnson | Marriage & Family Therapist | 331 E. Redwood Ave, Fort Bragg, CA 95437 | 2007-05-10 |
| 1528114741 | Kate Teresa Donohue | Psychologist | 19201 Noyo Acres Dr, Fort Bragg, CA 95437 | 2007-01-29 |
| Find all providers in zip 95437 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679633911 | Charmaine Fiona Kaula | Family Medicine | All American Hwy, Womack Army Medical Center, Fort Bragg, NC 28310 | 2006-12-09 |
| 1235129925 | Kathryn Robb O'donnell | Family Medicine | Building C-1722, Tagaytay & Gruber, Fort Bragg, NC 28310-0001 | 2005-10-25 |
| 1144838517 | Josephine Kariuki | Family Medicine | 2817 Reilly St, Fort Bragg, NC 28310-7324 | 2020-07-21 |
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| 1386269306 | Universal Mobile Doctors Inc | Family Medicine | 15333 Sherman Way Ste P, Van Nuys, CA 91406-4204 | 2020-06-16 |
| 1619597671 | Harry Eisenbach | Family Medicine | 9312 Smoketree Ln, Villa Park, CA 92861-1011 | 2020-04-20 |
| 1669092854 | Wellbeing Clinic Inc | Family Medicine | 1621 S New Hampshire Ave, Los Angeles, CA 90006-4513 | 2020-04-17 |
| 1619513611 | Krista Mckinney | Family Medicine | 344o E. La Palma Avenue, Anaheim, CA 92806 | 2019-11-25 |
| 1457995565 | Ucsf Medical Group Business Services | Family Medicine | 1100 Park Pl Ste 100, San Mateo, CA 94403-7119 | 2019-10-31 |
| 1780237313 | Charles Kim Md Inc | Family Medicine | 3055 W Orange Ave Ste 204, Anaheim, CA 92804-3154 | 2019-07-23 |
| 1083277206 | Baum 5 Star Healthcare | Family Medicine | 560 W Grangeville Blvd Ste A, Hanford, CA 93230-2858 | 2019-04-15 |
| 1477025278 | Connexus Family Clinic Inc | Family Medicine | 1930 E. Anaheim Street, N/a, Long Beach, CA 90813-3908 | 2018-12-19 |
| Find all providers with the same taxonomy | ||||
| City | FORT BRAGG |
| Zip Code | 95437 |
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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.