Provider Demographics
NPI:1174512941
Name:GOLDEN STATE HEALTH CENTERS, INC.
Entity type:Organization
Organization Name:GOLDEN STATE HEALTH CENTERS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF REIMBURSEMENT
Authorized Official - Prefix:MR
Authorized Official - First Name:NASEER
Authorized Official - Middle Name:AHMAD
Authorized Official - Last Name:CHOHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-385-3200
Mailing Address - Street 1:13347 VENTURA BLVD
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423
Mailing Address - Country:US
Mailing Address - Phone:818-385-3200
Mailing Address - Fax:818-385-3292
Practice Address - Street 1:13347 VENTURA BLVD
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-4267
Practice Address - Country:US
Practice Address - Phone:818-385-3200
Practice Address - Fax:818-385-3275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-14
Last Update Date:2018-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZT18570GMedicaid
CA056321Medicare ID - Type Unspecified