Provider Demographics
NPI:1598936585
Name:DR. GARY GOLD & ASSOCIATES OPTOMETRY
Entity Type:Organization
Organization Name:DR. GARY GOLD & ASSOCIATES OPTOMETRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:QT
Authorized Official - Last Name:PHAM-MURPHY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:408-736-3802
Mailing Address - Street 1:130 S SUNNYVALE AVE
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-6249
Mailing Address - Country:US
Mailing Address - Phone:408-736-3802
Mailing Address - Fax:408-736-6354
Practice Address - Street 1:130 S SUNNYVALE AVE
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94086-6249
Practice Address - Country:US
Practice Address - Phone:408-736-3802
Practice Address - Fax:408-736-6354
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-18
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6234152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T10271Medicare UPIN
SD0062340Medicare PIN