Provider Demographics
NPI:1275539462
Name:GOLD, JULIAN A (MD)
Entity Type:Individual
Prefix:
First Name:JULIAN
Middle Name:A
Last Name:GOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3530 WILSHIRE BLVD
Mailing Address - Street 2:STE 350
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90010-2335
Mailing Address - Country:US
Mailing Address - Phone:213-637-3703
Mailing Address - Fax:213-639-0790
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:# 8211
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90048-1804
Practice Address - Country:US
Practice Address - Phone:213-637-3703
Practice Address - Fax:213-639-0790
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2007-08-30
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
CAG41775207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA92287Medicare UPIN
CAWG41775AMedicare PIN