MEDICARE: MRS. MINDY GOLD M.S.

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	235Z00000X	Speech-Language Pathologist	15272	CA

General Provider Information

NPI Number	:	1942511415
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MINDY GOLD M.S.

Provider Business Mailing Address
First Line	:	4515 DON PIO DR
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-5308
Country	:	US
Telephone Number	:	818-884-4401
Fax Number	:

Provider Business Practice Location Address
First Line	:	4515 DON PIO DR
Second Line	:
City	:	WOODLAND HILLS
State	:	CA
Zip	:	91364-5308
Country	:	US
Telephone Number	:	818-884-4401
Fax Number	:

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

Provider Enumeration Date	:	06/29/2010
Last Update Date	:	06/29/2010

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Directions to “ MRS. MINDY GOLD M.S.” Practice Location

Language	Start Address	Practice Location

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