Provider Demographics
NPI:1538240833
Name:GOLDMAN, MITCHEL PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:MITCHEL
Middle Name:PAUL
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9339 GENESEE AVE
Mailing Address - Street 2:300
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-2119
Mailing Address - Country:US
Mailing Address - Phone:858-657-1002
Mailing Address - Fax:858-657-9392
Practice Address - Street 1:9339 GENESEE AVE
Practice Address - Street 2:300
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-2119
Practice Address - Country:US
Practice Address - Phone:858-657-1002
Practice Address - Fax:858-657-9392
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2011-08-08
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Provider Licenses
StateLicense IDTaxonomies
CAG50784207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology