Provider Demographics
NPI:1306909791
Name:GOLD, KATHRYN ANN (MD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:ANN
Last Name:GOLD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3855 HEALTH SCIENCES DR # 987
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0987
Mailing Address - Country:US
Mailing Address - Phone:858-822-5182
Mailing Address - Fax:858-822-6186
Practice Address - Street 1:3855 HEALTH SCIENCES DR # 987
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0987
Practice Address - Country:US
Practice Address - Phone:858-822-5182
Practice Address - Fax:858-822-6186
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2016-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT185750207R00000X
TXN0050207RH0003X
CA0139391207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U4993OtherBCBS
TX197981702Medicaid
TX8U4993OtherBCBS