Provider Demographics
NPI:1255525192
Name:RONALD L. GOLDSTEIN, O.D.
Entity type:Organization
Organization Name:RONALD L. GOLDSTEIN, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEFLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-495-4625
Mailing Address - Street 1:277 HAMPSHIRE RD
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2408
Mailing Address - Country:US
Mailing Address - Phone:805-495-4625
Mailing Address - Fax:805-496-2020
Practice Address - Street 1:277 HAMPSHIRE RD
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-2408
Practice Address - Country:US
Practice Address - Phone:805-495-4625
Practice Address - Fax:805-496-2020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-04
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4251T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA4898020001Medicare NSC
CAWY175Medicare PIN