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General NPI Number Information
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NPI Number | 1538962832
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Entity Type | Organization
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Legal Business Name | GOLDEN GATE HEALTH
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 603 E LATHAM AVE
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City | HEMET
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State | CA
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Zip | 92543-4342
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Country | US
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Telephone | 951-502-3500
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Fax |
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Provider Business Mailing Address
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Address Line | 603 E LATHAM AVE STE A
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City | HEMET
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State | CA
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Zip | 92543-4342
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Country | US
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Telephone | 951-502-3500
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Fax |
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Authorized Official
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Title or Position | COMMUNITY HEALTH WORKER
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Name | MR. CHRISTOPHERE NEAL KOLB III
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Credential | MEDICAL ASSISTANT
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Telephone | 951-502-3500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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