PAUL M GOODMAN MD A MEDICAL CORPORATION (NPI# 1912217522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912217522 |
| Entity Type | Organization |
| Organization Name | PAUL M GOODMAN MD A MEDICAL CORPORATION |
| Practice Address |
4033 3rd Ave Suite 104 San Diego CA 92103-2117 |
| Practice Telephone | 6192942351 |
| Practice Fax Number | 6192965719 |
| Mailing Telephone | 6192942351 |
| Mailing Fax Number | 6192965719 |
| Enumeration Date | 2010-10-15 |
| Last Update Date | 2010-10-15 |
| Authorized Official Name | PAUL M GOODMAN (PRESIDENT) |
| Authorized Official Telephone | 6192942350 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngology | G24856 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
4033 3RD AVE SUITE 104 |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92103-2117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871579722 | Scripps Clinic Medical Group | Clinic/Center | 4033 3rd Ave, Suite 210, San Diego, CA 92103-2117 | 2005-12-21 |
| 1811340227 | Sudhir Malik, A Professional Medical Corporation | Psychiatry & Neurology | 4033 3rd Ave, Suite 206, San Diego, CA 92103-2117 | 2016-07-20 |
| 1578972782 | Hillcrest Hearing Center | Hearing Aid Equipment | 4033 3rd Ave, Ste 104, San Diego, CA 92103-2117 | 2014-08-13 |
| 1659673994 | Gilda Tafreshi, Md, Inc. | Psychiatry & Neurology | 4033 3rd Ave, Suite 206, San Diego, CA 92103-2117 | 2010-11-18 |
| 1700100369 | Pierre G Rivet Md A Medical Corporation | Otolaryngology | 4033 3rd Ave, Suite 104, San Diego, CA 92103-2117 | 2010-03-25 |
| 1326370677 | Pacific Coast Surgical Group | Surgery | 4033 3rd Ave, Suite204, San Diego, CA 92103-2117 | 2010-02-10 |
| 1972757045 | Hillcrest Hearing Center Inc | Audiologist | 4033 3rd Ave, Suite 104, San Diego, CA 92103-2117 | 2008-11-16 |
| 1447443809 | Paul Alvord | Transplant Surgery | 4033 3rd Ave, Suite 204, San Diego, CA 92103-2117 | 2007-08-20 |
| 1366657603 | Cynthia Crist | Nurse Practitioner | 4033 3rd Ave, Suite 300, San Diego, CA 92103-2117 | 2007-05-11 |
| 1346388097 | Evan M Vapnek Md & James L Roberts Md, A Medical Group | Urology | 4033 3rd Ave, Suite 400, San Diego, CA 92103-2117 | 2007-02-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174140057 | Carmel Agdeppa | Acupuncturist | Chiropractique, 813 West Washington St., San Diego, CA 92103 | 2020-06-26 |
| 1568082717 | Salina Ann Bambic | Social Worker | 302 Washington Street Suite 420, San Diego, CA 92103 | 2020-04-17 |
| 1467099432 | Lina Hong | Behavior Technician | 3731 6th Ave. Suite 100, San Diego, Ca 92103, San Diego, CA 92103 | 2019-12-09 |
| 1154964567 | Rodger Stacy Questin, Psychologist P.C. | Psychologist | 440 Upas St Apt 402, San Diego, CA 92103 | 2019-10-18 |
| 1932740388 | Grace Tong-ventura | Pharmacist | 200 W. Arbor Drive, #8765, Suite 1-317, San Diego, CA 92103 | 2019-10-07 |
| 1306490453 | Genevieve Cheung | Pharmacist | 200 W Arbor Dr #8765, Department of Pharmacy, San Diego, CA 92103 | 2019-07-26 |
| 1801356837 | Marika Doviak | Acupuncturist | 2370 Hickory St, San Diego, CA 92103 | 2019-03-25 |
| 1982185070 | Tyler Lewis Roberts | Counselor | 4303 3rd Ave, San Diego, CA 92103 | 2018-08-27 |
| 1689151284 | Tori Breanne Blackwell | Occupational Therapist | 3731-a 6th Avenue, San Diego, CA 92103 | 2018-07-26 |
| 1952892614 | Pacific Bay Recovery Inc | Substance Abuse Rehabilitation Facility | 4095 Jackdaw St, San Diego, CA 92103 | 2018-05-29 |
| Find all providers in zip 92103 | ||||
| Taxonomy Code | 207Y00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Otolaryngology, 2007. http://www.aboto.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Otolaryngology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447663794 | Daniel Dewerd | Otolaryngology | 3627 Riviera Dr, San Diego, CA 92109-6641 | 2014-06-04 |
| 1003239948 | Jesse Qualliotine | Otolaryngology | 200 W Arbor Dr # 8895, San Diego, CA 92103 | 2014-01-29 |
| 1972931236 | Joseph Traxler | Otolaryngology | 12356 Avenida Consentido, San Diego, CA 92128-3283 | 2013-10-24 |
| 1174963532 | Ryan Anders Crane | Otolaryngology | Department of Otolaryngology - Nmc San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134 | 2013-07-01 |
| 1225395734 | Samantha Jill Hauff | Otolaryngology | 4282 Genesee Ave Ste 202, San Diego, CA 92117-4989 | 2012-04-20 |
| 1205064805 | Art Anthony Ambrosio | Otolaryngology | 34800 Bob Wilson Dr Ste 200, San Diego, CA 92134-2538 | 2009-06-23 |
| 1376600601 | Perry Mansfield, M.d., Inc. | Otolaryngology | 6645 Alvarado Rd # 4000, San Diego, CA 92120-5208 | 2007-01-03 |
| 1477612372 | Brent R Driskill | Otolaryngology | 4033 3rd Ave Ste 104, San Diego, CA 92103-2136 | 2006-12-06 |
| 1215005699 | Angela M Powell | Otolaryngology | 34520 Bob Wilson Dr Ste 200, San Diego, CA 92134-2200 | 2006-12-01 |
| 1144320599 | Marc E Kramer | Otolaryngology | 8929 University Center Lane, #208, San Diego, CA 92122 | 2006-09-25 |
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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.