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General NPI Number Information
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NPI Number | 1114728623
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Entity Type | Organization
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Legal Business Name | GOLDEN COAST HOMECARE
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 1101 CALIFORNIA AVE STE 203
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City | CORONA
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State | CA
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Zip | 92881-6473
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Country | US
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Telephone | 319-210-9160
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Fax |
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Provider Business Mailing Address
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Address Line | 427 18TH AVE APT 2
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-3165
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Country | US
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Telephone | 319-210-9160
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CRAIG FETT
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Credential |
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Telephone | 319-210-9160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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