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General NPI Number Information
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NPI Number | 1043798218
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Entity Type | Organization
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Legal Business Name | LILIYA GOLAS MD INC
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Dates
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Enumeration Date | 07/31/2018
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Last Update Date | 07/31/2018
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Provider Practice Location Address
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Address Line | 11216 TRINITY RIVER DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-2968
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Country | US
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Telephone | 916-635-6161
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Fax |
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Provider Business Mailing Address
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Address Line | 11216 TRINITY RIVER DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95670-2968
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Country | US
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Telephone | 916-635-6161
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LILIYA GOLAS
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Credential | MD
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Telephone | 916-872-7345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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