Healthcare Provider Details

I. General information

NPI: 1730307448
Provider Name (Legal Business Name): GOLDEN CASTLE ADHC CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2007
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3803 E BAYSHORE RD
PALO ALTO CA
94303-4300
US

IV. Provider business mailing address

3803 E BAYSHORE RD
PALO ALTO CA
94303-4300
US

V. Phone/Fax

Practice location:
  • Phone: 650-964-1964
  • Fax: 650-964-1978
Mailing address:
  • Phone: 650-964-1964
  • Fax: 650-964-1978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number070001316
License Number StateCA

VIII. Authorized Official

Name: OLEG KINDER
Title or Position: CEO
Credential:
Phone: 650-964-1964