Provider Demographics
NPI:1366550428
Name:GOLDMAN, JONATHAN HOWARD (MD)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:HOWARD
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:220 SUNNYCREST AVE
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2690
Mailing Address - Country:US
Mailing Address - Phone:650-743-7290
Mailing Address - Fax:650-745-0874
Practice Address - Street 1:220 SUNNYCREST AVE
Practice Address - Street 2:
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-2690
Practice Address - Country:US
Practice Address - Phone:650-743-7290
Practice Address - Fax:650-745-0874
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ME016689207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease