Provider Demographics
NPI:1518367846
Name:GOLDER STONE INTERNATIONAL, INC
Entity Type:Organization
Organization Name:GOLDER STONE INTERNATIONAL, INC
Other - Org Name:FOUR SEASONS ACUPUNCTURE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGE
Authorized Official - Prefix:MISS
Authorized Official - First Name:XIYAO
Authorized Official - Middle Name:
Authorized Official - Last Name:SHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-979-9298
Mailing Address - Street 1:46249 WARM SPRINGS BLVE,
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539
Mailing Address - Country:US
Mailing Address - Phone:510-979-9298
Mailing Address - Fax:
Practice Address - Street 1:46249 WARM SPRINGS BLVE SUITE 1
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539
Practice Address - Country:US
Practice Address - Phone:510-979-9298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2014-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA077975261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center