Provider Demographics
NPI:1508389305
Name:SIMONE GOLD INC
Entity Type:Organization
Organization Name:SIMONE GOLD INC
Other - Org Name:SIMONE GOLD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRINCIPAL
Authorized Official - Prefix:
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-210-6458
Mailing Address - Street 1:273 S CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4001
Mailing Address - Country:US
Mailing Address - Phone:310-210-6458
Mailing Address - Fax:310-210-6458
Practice Address - Street 1:273 S CRESCENT DR
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4001
Practice Address - Country:US
Practice Address - Phone:310-210-6458
Practice Address - Fax:310-210-6458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service