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Individual

DR. JEFFREY IRA GOLD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
4650 W SUNSET BLVD, MS# 12, LOS ANGELES, CA 90027-6062
(323) 669-2262
(323) 660-8983
Mailing address
3701 WILSHIRE BLVD, SUITE 600, LOS ANGELES, CA 90010-2814
(323) 669-2337
(323) 361-8491

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY19530
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PSY195300
CA
Enumeration date
09/27/2006
Last updated
06/01/2017
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