Healthcare Provider Details

I. General information

NPI: 1295061331
Provider Name (Legal Business Name): GOLDEN HEALTH THERAPEUTICS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/25/2009
Last Update Date: 10/25/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5680 LAKE MURRAY BLVD STE D
LA MESA CA
91942-1905
US

IV. Provider business mailing address

3618 WAGNER PL
SAN DIEGO CA
92123-2633
US

V. Phone/Fax

Practice location:
  • Phone: 858-292-8530
  • Fax:
Mailing address:
  • Phone: 858-292-8530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. PAUL BESGANS
Title or Position: OWNER
Credential:
Phone: 858-292-8530