Provider Demographics
NPI:1508837832
Name:PAN, GOLDEN (MD)
Entity Type:Individual
Prefix:DR
First Name:GOLDEN
Middle Name:
Last Name:PAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 39000
Mailing Address - Street 2:DEPT 34548
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-0001
Mailing Address - Country:US
Mailing Address - Phone:775-823-1999
Mailing Address - Fax:775-823-1996
Practice Address - Street 1:1155 MILL STREET
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89520-1576
Practice Address - Country:US
Practice Address - Phone:775-982-8100
Practice Address - Fax:775-982-4161
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV130792085R0202X
CAG511102085R0202X
TXG95082085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G511100Medicaid
CA00G511100OtherBS
CAWG51110JMedicare PIN
CAWG51110FMedicare PIN
CA00G511100OtherBS
CAWG51110KMedicare PIN
CAWG51110LMedicare PIN
CAWG51110MMedicare PIN
E04426Medicare UPIN
CAWG51110HMedicare PIN
CAWG51110GMedicare PIN
CAWG51110IMedicare PIN