MEDICARE: GOLDEN STATE SURGERY CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1003556333
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN STATE SURGERY CENTERS, LLC

Provider Business Mailing Address
First Line	:	1850 EL CAMINO REAL STE 200
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3102
Country	:	US
Telephone Number	:	650-697-2431
Fax Number	:

Provider Business Practice Location Address
First Line	:	1850 EL CAMINO REAL STE 200
Second Line	:
City	:	BURLINGAME
State	:	CA
Zip	:	94010-3102
Country	:	US
Telephone Number	:	650-697-2431
Fax Number	:

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	JAMES JOYE
Credential	:	DO
Telephone Number	:	714-766-5882

Provider Enumeration Date	:	04/01/2022
Last Update Date	:	04/01/2022

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