Individual
MADELINE GOULD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
565 N. MOUNT VERNON AVE, SAN BERNARDINO, CA 92411
(909) 884-9091
(909) 383-7013
Mailing address
565 N MOUNT VERNON AVE, SAN BERNARDINO, CA 92411-2661
(909) 884-9091
(909) 383-7013
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA23151
CA
Other
Enumeration date
09/12/2013
Last updated
09/12/2013
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