Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | G30602 | CA |
Y | 111NI0900X | Internist | G30602 | CA |
N | 207RN0300X | Nephrologist | G30602 | CA |
NPI | 1033220991 |
---|---|
Provider Name | Dr. Paul Golden |
First Address | Modesto, CA 95350-5341 |
Second Address | Modesto, CA 95350-5341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 28/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G306021 | (05) | CA |
A44480 | (02) | CA |