Provider Demographics
NPI:1265168223
Name:GOLUB, EKATERINA (OD)
Entity type:Individual
Prefix:DR
First Name:EKATERINA
Middle Name:
Last Name:GOLUB
Suffix:
Gender:
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11260 WHITE ROCK RD
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95742-6571
Mailing Address - Country:US
Mailing Address - Phone:916-724-2265
Mailing Address - Fax:
Practice Address - Street 1:11260 WHITE ROCK RD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95742-6571
Practice Address - Country:US
Practice Address - Phone:916-724-2265
Practice Address - Fax:916-357-7867
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35340152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist