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General NPI Number Information
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NPI Number | 1508389305
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Entity Type | Organization
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Legal Business Name | SIMONE GOLD INC
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 273 S CRESCENT DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4001
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Country | US
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Telephone | 310-210-6458
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Fax | 310-210-6458
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Provider Business Mailing Address
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Address Line | 273 S CRESCENT DR
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-4001
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Country | US
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Telephone | 310-210-6458
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Fax | 310-210-6458
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Authorized Official
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Title or Position | PRINCIPAL
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Name | SIMONE GOLD
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Credential | MD
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Telephone | 310-210-6458
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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