| Golden State Medical Center Pc | |
|
2551 San Ramon Valley Blvd Ste 108 San Ramon CA 94583-1661 | |
| (925) 838-4462 | |
| Not Available |
| Full Name | Golden State Medical Center Pc |
|---|---|
| Speciality | General Practice |
| Location | 2551 San Ramon Valley Blvd Ste 108, San Ramon, California |
| Authorized Official Name and Position | Steven Scott Newman (OWNER) |
| Authorized Official Contact | 9258384462 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden State Medical Center Pc 2551 San Ramon Valley Blvd Ste 108 San Ramon CA 94583-1661 Ph: (925) 838-4462 | Golden State Medical Center Pc 2551 San Ramon Valley Blvd Ste 108 San Ramon CA 94583-1661 Ph: (925) 838-4462 |
| NPI Number | 1851999627 |
|---|---|
| Provider Enumeration Date | 10/14/2020 |
| Last Update Date | 09/22/2023 |
| Medicare PECOS PAC ID | 2365857612 |
|---|---|
| Medicare Enrollment ID | O20210218000525 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851999627 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Angela Cassagne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548881618 PECOS PAC ID: 5890100705 Enrollment ID: I20210225003107 |
| Provider Name | Tricia R Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902299506 PECOS PAC ID: 7012216187 Enrollment ID: I20220803001700 |
| Provider Name | Kimmie Lia Luong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851030746 PECOS PAC ID: 9234583717 Enrollment ID: I20231003000305 |
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