MEDICARE: GOLDEN STATE ORTHOPEDICS & SPINE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1972309920
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN STATE ORTHOPEDICS & SPINE

Provider Business Mailing Address
First Line	:	PO BOX 31396
Second Line	:
City	:	WALNUT CREEK
State	:	CA
Zip	:	94598-8396
Country	:	US
Telephone Number	:	925-256-2107
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 SAND CREEK RD STE A
Second Line	:
City	:	BRENTWOOD
State	:	CA
Zip	:	94513-2539
Country	:	US
Telephone Number	:	925-939-8585
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	STEPHEN HAMMARSTROM
Credential	:
Telephone Number	:	925-256-2107

Provider Enumeration Date	:	02/20/2025
Last Update Date	:	02/20/2025

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