Provider Demographics
NPI:1477620151
Name:GOULD, BRAD H (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:H
Last Name:GOULD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2333 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1763
Mailing Address - Country:US
Mailing Address - Phone:925-743-7887
Mailing Address - Fax:925-743-1937
Practice Address - Street 1:2333 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE 125
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1763
Practice Address - Country:US
Practice Address - Phone:925-743-7887
Practice Address - Fax:925-743-1937
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG321652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G321650Medicare ID - Type UnspecifiedMEDICARE