GLENN I. GOLDBERG, D.O., A PROFESSIONAL MEDICAL CORPORATION
Medical Practice at Coast Hwy, Laguna Beach, CA

License number
California 20A5649
Category
Medical Practice
Type
Specialist
Owner
Name: GLENN I GOLDBERG D.O.
Title: OWNER
Phone: (949) 499-1389
Address
Address
31852 Coast Hwy SUITE 300, Laguna Beach, CA 92651
National Provider ID: 1205051083
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GLENN I. GOLDBERG, D.O., A PROFESSIONAL MEDICAL CORPORATION

31852 Coast Hwy STE 300, Laguna Beach, CA 92651

Registration:
Jan 2, 2001
State ID:
C2301688
Business type:
Articles of Incorporation
President:
Glenn I. Goldberg (President)
Agent:
Gina M Fahl,Laguna Beach, CA 92651 (Physical)

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