Healthcare Provider Details

I. General information

NPI: 1053909556
Provider Name (Legal Business Name): GOLDEN STATE HEARING AID CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2021
Last Update Date: 01/10/2021
Certification Date: 01/10/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3995 N FRESNO ST STE 106
FRESNO CA
93726-4031
US

IV. Provider business mailing address

200 W ROSEBURG AVE STE B2
MODESTO CA
95350-5200
US

V. Phone/Fax

Practice location:
  • Phone: 559-354-0340
  • Fax: 559-354-0341
Mailing address:
  • Phone: 209-287-3272
  • Fax: 209-287-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332S00000X
TaxonomyHearing Aid Equipment
License Number
License Number State

VIII. Authorized Official

Name: RYAN HOLDEN
Title or Position: PRESIDENT
Credential:
Phone: 209-287-3272