Provider Demographics
NPI:1134864036
Name:MICHAEL E. GOLD, M.D., INC.
Entity type:Organization
Organization Name:MICHAEL E. GOLD, M.D., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN AND SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:GOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD, INC
Authorized Official - Phone:310-829-2126
Mailing Address - Street 1:2021 SANTA MONICA BLVD STE 525E
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2162
Mailing Address - Country:US
Mailing Address - Phone:310-829-2126
Mailing Address - Fax:310-998-8887
Practice Address - Street 1:2021 SANTA MONICA BLVD STE 525E
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2162
Practice Address - Country:US
Practice Address - Phone:310-829-2126
Practice Address - Fax:310-998-8887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-04
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty