MEDICARE: DR. MICHAEL GERARD GOLDER M.D.

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
1	2084P0800X	Psychiatry Physician	268082	NY
2	2084P0800X	Psychiatry Physician	G141046	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760455778
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHAEL GERARD GOLDER M.D.

Provider Business Mailing Address
First Line	:	191 S BUENA VISTA ST STE 300
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4556
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 S BUENA VISTA ST STE 300
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4556
Country	:	US
Telephone Number	:	925-282-1778
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	11/03/2025

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