Healthcare Provider Details

I. General information

NPI: 1285553107
Provider Name (Legal Business Name): GO SERVICE SUCCESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2026
Last Update Date: 07/14/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22225 SEINE AVE
HAWAIIAN GARDENS CA
90716
US

IV. Provider business mailing address

11278 LOS ALAMITOS BLVD UNIT 977
LOS ALAMITOS CA
90720-3958
US

V. Phone/Fax

Practice location:
  • Phone: 714-406-3992
  • Fax:
Mailing address:
  • Phone: 714-406-3992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ROM HIM
Title or Position: OWNER
Credential:
Phone: 714-406-3992