Healthcare Provider Details

I. General information

NPI: 1386151769
Provider Name (Legal Business Name): GOLDEN STATE HEARING AID CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2018
Last Update Date: 06/06/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 COLLEGE AVE. SUITE 1A
MODESTO CA
95350-5979
US

IV. Provider business mailing address

101 COLLEGE AVE. SUITE 1A
MODESTO CA
95350-5979
US

V. Phone/Fax

Practice location:
  • Phone: 209-287-3272
  • Fax: 209-287-3232
Mailing address:
  • Phone: 209-287-3272
  • Fax: 209-287-3232

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHA7332
License Number StateCA

VIII. Authorized Official

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