Gold, Jeffrey Ira

Gold, Jeffrey Ira is an individual health care provider with primary practice located at 4650 W Sunset Blvd Ms# 12, Los Angeles CA 90027-6062. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical Child & Adolescent, which is considered as his primary health care specialty. Gold, Jeffrey Ira can be contacted via phone (323) 669-2262.

Contact Information

Primary practice address
4650 W Sunset Blvd Ms# 12 Los Angeles CA 90027-6062
Phone: (323) 669-2262
Fax: (323) 660-8983
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical Child & Adolescent 103TC2200X PSY19530 California

Profile Details

NPI number 1225129166
LBN Legal business name Gold, Jeffrey Ira
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 27th, 2006
Last updated Jun 1st, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225129166 NPPES
California MEDICAID PSY195300

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