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General NPI Number Information
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NPI Number | 1295050771
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Entity Type | Organization
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Legal Business Name | GOLDEN GATE ENT CORPORATION
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Dates
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Enumeration Date | 03/29/2010
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 1711 TARAVAL ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94116-2308
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Country | US
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Telephone | 415-682-8181
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Fax |
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Provider Business Mailing Address
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Address Line | 270 SAN ANSELMO AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94127-2049
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Country | US
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Telephone |
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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. KI HONG HO
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Credential | M.D.
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Telephone | 415-682-8181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | A110838
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License Number State | CA
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