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General NPI Number Information
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NPI Number | 1881827194
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Entity Type | Organization
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Legal Business Name | GILDED AGE INC.
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Dates
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Enumeration Date | 09/02/2009
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 2483 OLD MIDDLEFIELD WAY SUITE 201
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94043-2359
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Country | US
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Telephone | 650-965-0600
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Fax | 650-965-0603
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Provider Business Mailing Address
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Address Line | 2483 OLD MIDDLEFIELD WAY SUITE 201
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94043-2359
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Country | US
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Telephone | 650-965-0600
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Fax | 650-965-0603
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Authorized Official
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Title or Position | OWNER/FRANCHISEE
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Name | DR. EMMANUIL H LINGUNIS
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Credential | PH.D.
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Telephone | 650-965-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 47700
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License Number State | CA
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