| Golden Shore Medical Group | |
|
6339 Mack Rd Sacramento CA 95823-4655 | |
| (916) 585-7912 | |
| (877) 479-7101 |
| Full Name | Golden Shore Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 6339 Mack Rd, Sacramento, California |
| Authorized Official Name and Position | Gloria Calderon (PRESIDENT, AFC) |
| Authorized Official Contact | 6263462455 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Shore Medical Group 625 Fair Oaks Ave Ste 270 South Pasadena CA 91030-5801 Ph: (626) 346-2455 | Golden Shore Medical Group 6339 Mack Rd Sacramento CA 95823-4655 Ph: (916) 585-7912 |
| NPI Number | 1417360686 |
|---|---|
| Provider Enumeration Date | 06/05/2014 |
| Last Update Date | 02/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417360686 | NPI | - | NPPES |
| EFFECTIVE 1/5/15 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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