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NPI Code Detail

MEDICARE: SETH GOLD ACSW

MEDICARE: SETH GOLD ACSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerCA

General Provider Information

NPI Number : 1255989471
Entity Type Code : Individual
Provider Name (Legal Business Name) : SETH GOLD ACSW
Provider Business Mailing Address
First Line : 5239 TENDILLA AVE
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91364-1830
Country : US
Telephone Number : 818-486-3216
Fax Number :
Provider Business Practice Location Address
First Line : 303 E 52ND ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90011-4513
Country : US
Telephone Number : 323-918-2139
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2019
Last Update Date : 08/30/2019

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Directions to “ SETH GOLD ACSW” Practice Location

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