Provider Demographics
NPI:1609890573
Name:GOLDEN, PATRICK ALLEN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:ALLEN
Last Name:GOLDEN
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 1:1275 E SPRUCE AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-3372
Mailing Address - Country:US
Mailing Address - Phone:559-432-0716
Mailing Address - Fax:559-432-4545
Practice Address - Street 1:1275 E SPRUCE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3372
Practice Address - Country:US
Practice Address - Phone:559-432-0716
Practice Address - Fax:559-432-4545
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG51665207RC0000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G516650Medicare ID - Type Unspecified
CAA52049Medicare UPIN