Provider Demographics
NPI:1114924792
Name:GOLD, ALEX (MD)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2021 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 440 E
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2208
Mailing Address - Country:US
Mailing Address - Phone:310-453-1386
Mailing Address - Fax:310-453-4786
Practice Address - Street 1:2021 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 440 E
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2208
Practice Address - Country:US
Practice Address - Phone:310-453-1386
Practice Address - Fax:310-453-4786
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-28
Last Update Date:2010-08-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA89939207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine