Provider Demographics
NPI:1255140323
Name:GOLDEN AGE ENTERPRISES
Entity type:Organization
Organization Name:GOLDEN AGE ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SOHEILA
Authorized Official - Middle Name:
Authorized Official - Last Name:VAKILI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-401-2040
Mailing Address - Street 1:513 PARKWAY PLZ
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92020-2531
Mailing Address - Country:US
Mailing Address - Phone:619-401-2040
Mailing Address - Fax:619-201-8470
Practice Address - Street 1:513 PARKWAY PLZ
Practice Address - Street 2:
Practice Address - City:EL CAJON
Practice Address - State:CA
Practice Address - Zip Code:92020-2531
Practice Address - Country:US
Practice Address - Phone:619-401-2040
Practice Address - Fax:619-201-8470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-03
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health