Provider Demographics
NPI:1881827194
Name:GILDED AGE INC.
Entity Type:Organization
Organization Name:GILDED AGE INC.
Other - Org Name:BRIGHTSTAR OF LOS ALTOS, PALO ALTO, AND MOUNTAIN VIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/FRANCHISEE
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMANUIL
Authorized Official - Middle Name:H
Authorized Official - Last Name:LINGUNIS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:650-965-0600
Mailing Address - Street 1:2483 OLD MIDDLEFIELD WAY
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-2359
Mailing Address - Country:US
Mailing Address - Phone:650-965-0600
Mailing Address - Fax:650-965-0603
Practice Address - Street 1:2483 OLD MIDDLEFIELD WAY
Practice Address - Street 2:SUITE 201
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-2359
Practice Address - Country:US
Practice Address - Phone:650-965-0600
Practice Address - Fax:650-965-0603
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GILDED AGE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-09-02
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47700251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health