MEDICARE: GOLDEN HEALTH CLINIC 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	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1871394494
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDEN HEALTH CLINIC LLC

Provider Business Mailing Address
First Line	:	5599 ROLLINS ST
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89118-6050
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5510 S FORT APACHE RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148
Country	:	US
Telephone Number	:	702-900-9888
Fax Number	:	888-316-6618

Authorized Official
Title or Position	:	OWNER
Name	:	PENGFENG JACK JIN
Credential	:	MD
Telephone Number	:	702-900-9888

Provider Enumeration Date	:	03/20/2025
Last Update Date	:	01/14/2026

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