GOLDEN STATE DERMATOLOGY ASSOCIATES INC. NPI 1235738576

NPI Information

NPI: 1235738576
Provider Name: GOLDEN STATE DERMATOLOGY ASSOCIATES, INC.
Classification: Clinic/Center - 261QA1903X
Entity Type: Organization

Specialization: Ambulatory Surgical

CLIA Number: 05D0912897

Address:
6769 N FRESNO ST
FRESNO, CA
ZIP 93710
Phone: (559) 435-0337
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GOLDEN STATE DERMATOLOGY ASSOCIATES, INC. is an ambulatory surgical clinic center in Fresno, CA. GOLDEN STATE DERMATOLOGY ASSOCIATES, INC. NPI is 1235738576. The provider is registered as an organization entity type.

The provider's business location address is:

6769 N FRESNO ST
FRESNO, CA
ZIP 93710-715
Phone: (559) 435-0337

The provider's authorized official is Jeffrey Thomas Bortz .
The authorized official title is Authorized Official and has the following contact phone number (925) 932-7704.

The CLIA number assigned to this NPI record is 05D0912897 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 10/19/2020 and was last updated on 10/19/2020.

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:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QA1903X	Clinic/Center	Ambulatory Surgical			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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