Provider Demographics
NPI:1376834309
Name:GINGOLD, DANIEL SETH (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:SETH
Last Name:GINGOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16311 VENTURA BLVD
Mailing Address - Street 2:STE 505
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-4309
Mailing Address - Country:US
Mailing Address - Phone:917-509-5256
Mailing Address - Fax:
Practice Address - Street 1:1378 3RD AVE
Practice Address - Street 2:APT 3C
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0457
Practice Address - Country:US
Practice Address - Phone:917-509-5256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-25
Last Update Date:2017-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY259877208600000X
CAA116809208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery