Provider Demographics
NPI:1437796059
Name:GOLDEN STAR MEDICAL GROUP
Entity Type:Organization
Organization Name:GOLDEN STAR MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:XINGZHI
Authorized Official - Middle Name:
Authorized Official - Last Name:LUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-420-1779
Mailing Address - Street 1:4500 EL CAMINO REAL STE 3
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-6503
Mailing Address - Country:US
Mailing Address - Phone:408-420-1779
Mailing Address - Fax:
Practice Address - Street 1:4500 EL CAMINO REAL STE 3
Practice Address - Street 2:
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94022-6503
Practice Address - Country:US
Practice Address - Phone:408-420-1779
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty