Provider Demographics
NPI:1235562679
Name:GOLDEN CARE MEDICAL GROUP INC
Entity Type:Organization
Organization Name:GOLDEN CARE MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LARS
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:626-375-1505
Mailing Address - Street 1:8811 GARVEY AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ROSEMEAD
Mailing Address - State:CA
Mailing Address - Zip Code:91770-2476
Mailing Address - Country:US
Mailing Address - Phone:626-927-9794
Mailing Address - Fax:626-975-0779
Practice Address - Street 1:8811 GARVEY AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ROSEMEAD
Practice Address - State:CA
Practice Address - Zip Code:91770-2476
Practice Address - Country:US
Practice Address - Phone:626-927-9794
Practice Address - Fax:626-795-0779
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-20
Last Update Date:2013-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty