Provider Demographics
NPI:1174375653
Name:GOLDEN BEGINNINGS PEDIATRIC THERAPY SERVICES SAN DIEGO PC, CORP
Entity type:Organization
Organization Name:GOLDEN BEGINNINGS PEDIATRIC THERAPY SERVICES SAN DIEGO PC, CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OTD
Authorized Official - Prefix:
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZGODA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-775-6446
Mailing Address - Street 1:1870 CHALCEDONY ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-3233
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3095 N IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:EL CENTRO
Practice Address - State:CA
Practice Address - Zip Code:92243-6319
Practice Address - Country:US
Practice Address - Phone:760-355-8383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty