MEDICARE: GOLD COUNTRY HEALTH CENTER

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	314000000X	Skilled Nursing Facility	030000229	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588669865
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD COUNTRY HEALTH CENTER

Provider Business Mailing Address
First Line	:	4301 GOLDEN CENTER DR
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6260
Country	:	US
Telephone Number	:	530-621-1100
Fax Number	:	530-621-1104

Provider Business Practice Location Address
First Line	:	4301 GOLDEN CENTER DR
Second Line	:
City	:	PLACERVILLE
State	:	CA
Zip	:	95667-6260
Country	:	US
Telephone Number	:	530-621-1100
Fax Number	:	530-621-1104

Authorized Official
Title or Position	:	V.P. OF OPERATIONS
Name	:	STUART HARTMAN
Credential	:
Telephone Number	:	562-257-5100

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	10/11/2013

Similar Medicare Providers

1558367102 — DR. WILLIAM KOBLE M.D.
Practice Location Address:

4341 GOLDEN CENTER DR , SUITE B
PLACERVILLE, CA
95667-6260

Practice Phone: 530-621-3600
Practice Fax:

1457342875 — ULRICH B HACKER MD
Practice Location Address:

4341 GOLDEN CENTER DR , SUITE A
PLACERVILLE, CA
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1700868361 — ELIZABETH K PETERSON MD
Practice Location Address:

4341 GOLDEN CENTER DR , SUITE A
PLACERVILLE, CA
95667-6260

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Practice Fax: 530-626-7146

1679546600 — BRETT D CHRISTIANSEN MD
Practice Location Address:

4341 GOLDEN CENTER DR , SUITE A
PLACERVILLE, CA
95667-6260

Practice Phone: 530-626-1144
Practice Fax:

1689601155 — GARY W.O. YOUNG M.D.
Practice Location Address:

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PLACERVILLE, CA
95667-6260

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1023022811 — DR. INJOO HAN D.D.S.
Practice Location Address:

4355 GOLDEN CENTER DR STE A
PLACERVILLE, CA
95667-6260

Practice Phone: 530-622-3430
Practice Fax: 530-622-9733

Directions to “GOLD COUNTRY HEALTH CENTER ” Practice Location

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