Healthcare Provider Details

I. General information

NPI: 1982246575
Provider Name (Legal Business Name): GOLDEN STATE HEART & VASCULAR ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2019
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 EL CAMINO REAL STE 200
BURLINGAME CA
94010
US

IV. Provider business mailing address

1850 EL CAMINO REAL STE 200
BURLINGAME CA
94010-3102
US

V. Phone/Fax

Practice location:
  • Phone: 650-697-2431
  • Fax:
Mailing address:
  • Phone: 650-697-2431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: JAMES JOYE
Title or Position: PRESIDENT
Credential: MD
Phone: 650-697-2431