MEDICARE: MAUREEN GOTTFRIED DO

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	2084N0400X	Neurology Physician	20A24684	CA
2	2084N0600X	Clinical Neurophysiology Physician	20A24684	CA

General Provider Information

NPI Number	:	1972652832
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREEN GOTTFRIED DO

Provider Business Mailing Address
First Line	:	72780 COUNTRY CLUB DR STE 205
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-4150
Country	:	US
Telephone Number	:	760-834-3540
Fax Number	:	760-834-3590

Provider Business Practice Location Address
First Line	:	72780 COUNTRY CLUB DR STE 205
Second Line	:
City	:	RANCHO MIRAGE
State	:	CA
Zip	:	92270-4150
Country	:	US
Telephone Number	:	760-834-3540
Fax Number	:	760-834-3590

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

Provider Enumeration Date	:	01/09/2007
Last Update Date	:	02/17/2026

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Directions to “ MAUREEN GOTTFRIED DO” Practice Location

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