GOLDOME HEALTHCARE INC. NPI 1295154672

NPI Information

NPI: 1295154672
Provider Name: GOLDOME HEALTHCARE INC.
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 05D2078948

Address:
2705 S DIAMOND BAR BLVD STE 100
DIAMOND BAR, CA
ZIP 91765
Phone: (626) 965-1988
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GOLDOME HEALTHCARE INC. is a primary care clinic center in Diamond Bar, CA. GOLDOME HEALTHCARE INC. NPI is 1295154672. The provider is registered as an organization entity type.

The provider's business location address is:

2705 S DIAMOND BAR BLVD STE 100
DIAMOND BAR, CA
ZIP 91765-557
Phone: (626) 965-1988

The provider's authorized official is David T Chen .
The authorized official title is President and has the following contact phone number (951) 334-1939.

The CLIA number assigned to this NPI record is 05D2078948 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/14/2014 and was last updated on 7/17/2019.

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	261QP2300X	Clinic/Center	Primary Care	A82411	CALIFORNIA	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: 11/14/2023

NPI Synchronization or Removal

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