Provider Demographics
NPI:1386651230
Name:GOLDEN, JOEL G (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:G
Last Name:GOLDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:75 REMITTANCE DR DEPT 6008
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60675-6008
Mailing Address - Country:US
Mailing Address - Phone:562-282-1419
Mailing Address - Fax:562-920-4642
Practice Address - Street 1:10234 ROSECRANS AVE
Practice Address - Street 2:
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-2602
Practice Address - Country:US
Practice Address - Phone:562-920-1632
Practice Address - Fax:562-920-4643
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG26683207RN0300X
CA26683207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G266830OtherBLUE SHIELD
CA00G266830Medicaid
CA390007948OtherRAILROAD MEDICARE
CA00G266830Medicaid
CA390007948OtherRAILROAD MEDICARE