Provider Demographics
NPI:1801913306
Name:ARNOLD W GOLDSCHLAGER MD MEDICAL CORPORATION
Entity type:Organization
Organization Name:ARNOLD W GOLDSCHLAGER MD MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARNOLD
Authorized Official - Middle Name:W
Authorized Official - Last Name:GOLDSCHLAGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-697-7643
Mailing Address - Street 1:1828 EL CAMINO REAL STE 402
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3115
Mailing Address - Country:US
Mailing Address - Phone:650-697-7643
Mailing Address - Fax:650-697-7895
Practice Address - Street 1:1750 EL CAMINO REAL SUITE 11
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010
Practice Address - Country:US
Practice Address - Phone:650-994-4650
Practice Address - Fax:650-552-9785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG14606174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty