Provider Demographics
NPI:1215996640
Name:GOLDMAN, ALLAN P (DO)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:P
Last Name:GOLDMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4350 E CAMELBACK RD
Mailing Address - Street 2:STE. F-100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2701
Mailing Address - Country:US
Mailing Address - Phone:602-955-8700
Mailing Address - Fax:602-553-8142
Practice Address - Street 1:4350 E CAMELBACK RD
Practice Address - Street 2:STE. F-100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2701
Practice Address - Country:US
Practice Address - Phone:602-955-8700
Practice Address - Fax:602-553-8142
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ1027207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1027OtherSTATE LICENSE
AZ1027OtherSTATE LICENSE
AZE44463Medicare UPIN