Provider Demographics
NPI:1235140468
Name:RICHARD E. GOULD, M.D., A PROFESSIONAL MEDICAL CORPORATION
Entity Type:Organization
Organization Name:RICHARD E. GOULD, M.D., A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-659-1848
Mailing Address - Street 1:PO BOX 93141
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90093-0141
Mailing Address - Country:US
Mailing Address - Phone:310-659-1848
Mailing Address - Fax:310-423-7294
Practice Address - Street 1:8700 BEVERLY BLVD. AC-1110
Practice Address - Street 2:CEDARS-SINAI COMPREHENSIVE CANCER CENTER
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-659-1848
Practice Address - Fax:310-423-7294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-11
Last Update Date:2012-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73353207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty