Provider Demographics
NPI:1043798218
Name:LILIYA GOLAS MD INC
Entity Type:Organization
Organization Name:LILIYA GOLAS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LILIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-872-7345
Mailing Address - Street 1:11216 TRINITY RIVER DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2968
Mailing Address - Country:US
Mailing Address - Phone:916-635-6161
Mailing Address - Fax:
Practice Address - Street 1:11216 TRINITY RIVER DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2968
Practice Address - Country:US
Practice Address - Phone:916-635-6161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-31
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1346509205OtherINDIVIDUAL NPI
CA=========OtherIRS EIN