Scott Kelly Goddard, OMS
Emergency Medicine in Fresno, CA. Individual provider (NPI-1).
NPI number1649705484
StatusActive
Last updated in NPPESOct 24, 2022
Details
- NPI
- 1649705484
- Entity type
- Individual (NPI-1)
- Name
- Scott Kelly Goddard
- Credential
- OMS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 1, 2017
- Certification date
- Oct 24, 2022
- Last updated
- Oct 24, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207P00000X | Emergency Medicine | 20A20290 | CA | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | OR |
Practice location
155 N Fresno StFresno, CA 93701-2302
Phone 559-499-6440
Mailing address
155 N Fresno StFresno, CA 93701-2302
Phone 559-499-6440
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