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General NPI Number Information
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NPI Number | 1750306155
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Entity Type | Individual
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Provider Name | MICHAEL EDWARD GOLD MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 09/05/2008
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Provider Practice Location Address
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Address Line | 2021 SANTA MONICA BLVD SUITE 525E
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City | SANTA MONICA
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State | CA
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Zip | 90404-2208
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Country | US
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Telephone | 310-829-2126
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Fax | 310-998-8887
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Provider Business Mailing Address
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Address Line | 2021 SANTA MONICA BLVD SUITE # 525E
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City | SANTA MONICA
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State | CA
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Zip | 90404-2208
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Country | US
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Telephone | 310-829-2126
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Fax | 310-998-8887
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | G47870
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License Number State | CA
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