Individual provider Active NPI

Michael Gary Gold, M.D.

  • Pediatrics Physician
  • Camarillo, CA
National Provider Identifier
1215932058
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
G33451 Issued in CA
Practice address
2486 Ponderosa Dr Worth
Suite D-211
Camarillo, CA 93010-2367
Phone
(805) 484-2818
Fax
(805) 482-0028
NPI assigned
Jun 17, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X G33451 CA Primary

Addresses

Primary practice location

2486 Ponderosa Dr Worth
Suite D-211
Camarillo, CA 93010-2367

Mailing address

2486 Ponderosa Dr Worth
Suite D-211
Camarillo, CA 93010-2367
Phone (805) 484-2818

Other identifiers 1

IdentifierTypeStateIssuer
ZZZ75674ZMedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160331002157 CA Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3274830567

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G33451CAMDPediatrics Physician
33451CAMDSpeech-Language Pathologist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1118966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1215932058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2486 PONDEROSA DR WORTH",
            "address_2": "SUITE D-211",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102367",
            "telephone_number": "805-484-2818",
            "fax_number": "805-482-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2486 PONDEROSA DR WORTH",
            "address_2": "SUITE D-211",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930102367",
            "telephone_number": "805-484-2818",
            "fax_number": "805-482-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLD",
        "first_name": "MICHAEL",
        "middle_name": "GARY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "G33451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZZ75674Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camarillo, CA

Sources for this page

Verify at the official NPI Registry.