Provider Demographics
NPI:1518250976
Name:GOLDEN STATE HOME HEALTH CARE & HOSPICE INC.
Entity Type:Organization
Organization Name:GOLDEN STATE HOME HEALTH CARE & HOSPICE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:IQBAL
Authorized Official - Middle Name:NASSEEM
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-832-2224
Mailing Address - Street 1:324 E 11TH ST
Mailing Address - Street 2:H2-H3
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-4071
Mailing Address - Country:US
Mailing Address - Phone:209-832-2224
Mailing Address - Fax:209-832-2226
Practice Address - Street 1:324 E 11TH ST
Practice Address - Street 2:H2 & H3
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-4071
Practice Address - Country:US
Practice Address - Phone:209-830-1311
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-18
Last Update Date:2017-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251G00000XAgenciesHospice Care, Community Based
No251E00000XAgenciesHome Health