Provider Demographics
NPI:1851602320
Name:GOLDEN SERVICE GROUP
Entity Type:Organization
Organization Name:GOLDEN SERVICE GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAVAD
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMADIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-851-4150
Mailing Address - Street 1:17530 VENTURA BLVD
Mailing Address - Street 2:#105
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-3818
Mailing Address - Country:US
Mailing Address - Phone:818-300-0025
Mailing Address - Fax:818-382-2270
Practice Address - Street 1:17530 VENTURA BLVD
Practice Address - Street 2:#105
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91316-3818
Practice Address - Country:US
Practice Address - Phone:818-300-0025
Practice Address - Fax:818-382-2270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343800000XTransportation ServicesSecured Medical Transport (VAN)