Healthcare Provider Details

I. General information

NPI: 1932858024
Provider Name (Legal Business Name): ALEXANDER JAY GOULD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10833 LE CONTE AVE # CHS27139
LOS ANGELES CA
90095-3075
US

IV. Provider business mailing address

10833 LE CONTE AVE # CHS27139
LOS ANGELES CA
90095-3075
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-9945
  • Fax:
Mailing address:
  • Phone: 310-825-9945
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberDR.0077342
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberDR.0077342
License Number StateCO
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDR.0077342
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: