Healthcare Provider Details

I. General information

NPI: 1952550097
Provider Name (Legal Business Name): GOLDENCAST MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2008
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 S BEDFORD ST SUITE 301
LOS ANGELES CA
90035-1989
US

IV. Provider business mailing address

929 S BEDFORD ST SUITE 301
LOS ANGELES CA
90035-1989
US

V. Phone/Fax

Practice location:
  • Phone: 626-442-5200
  • Fax: 866-931-3134
Mailing address:
  • Phone: 626-765-4302
  • Fax: 310-657-8728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA96880
License Number StateCA

VIII. Authorized Official

Name: DR. SHAHRIAR JARCHI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 626-765-4321