Provider Demographics
NPI:1366077703
Name:GOLDEN NATURAL MEDICAL GROUP
Entity type:Organization
Organization Name:GOLDEN NATURAL MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PEI
Authorized Official - Middle Name:
Authorized Official - Last Name:H
Authorized Official - Suffix:
Authorized Official - Credentials:LAC
Authorized Official - Phone:650-422-8148
Mailing Address - Street 1:2949 S WHITE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-3541
Mailing Address - Country:US
Mailing Address - Phone:650-422-8148
Mailing Address - Fax:
Practice Address - Street 1:1670 WESTWOOD DR STE J
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-5111
Practice Address - Country:US
Practice Address - Phone:650-422-8148
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-05
Last Update Date:2020-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty