Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 6234 | CA |
N | 152WC0802X | Optomitrist - Corneal and Contact Lenses | 6234 | CA |
NPI | 1316996150 |
---|---|
Provider Name | Dr. Gary M Gold |
First Address | Sunnyvale, CA 94086-6249 |
Second Address | Sunnyvale, CA 94086-6249 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2006 |
Last Update Date | 26/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6234 | LICENSE (01) | CA |
MG00641262 | DEA (01) | CA |
T10271 | (02) | CA |