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General NPI Number Information
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NPI Number | 1891458121
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Entity Type | Organization
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Legal Business Name | GOLDEN STATE PAIN SOLUTIONS INC
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 12/22/2021
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Provider Practice Location Address
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Address Line | 8341 FAIR OAKS BLVD STE C
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City | CARMICHAEL
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State | CA
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Zip | 95608-1905
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Country | US
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Telephone | 916-999-0670
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Fax |
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Provider Business Mailing Address
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Address Line | 8341 FAIR OAKS BLVD STE C
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City | CARMICHAEL
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State | CA
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Zip | 95608-1905
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Country | US
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Telephone | 916-999-0670
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DARRYL A BATES
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Credential | MD
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Telephone | 916-999-0670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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