GOLDEN STATE OTOLARYNGOLOGY MEDICAL NPI 1174794408

NPI Information

GOLDEN STATE OTOLARYNGOLOGY MEDICAL is a specialist in Ridgecrest, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. GOLDEN STATE OTOLARYNGOLOGY MEDICAL NPI is 1174794408. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Gsomc-billing.

The provider's business location address is:

301 DRUMMOND AVE
RIDGECREST, CA
ZIP 93555-187
Phone: (760) 371-7329
Fax: (661) 726-6291

The provider's authorized official is Ruwanthi S Campano .
The authorized official title is President and has the following contact phone number (661) 726-6277.

The enumeration date for this NPI number is 3/14/2008 and was last updated on 8/12/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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