Provider Demographics
NPI:1053909556
Name:GOLDEN STATE HEARING AID CENTER, INC.
Entity type:Organization
Organization Name:GOLDEN STATE HEARING AID CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-287-3272
Mailing Address - Street 1:200 W ROSEBURG AVE STE B2
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-5200
Mailing Address - Country:US
Mailing Address - Phone:209-287-3272
Mailing Address - Fax:209-287-3232
Practice Address - Street 1:3995 N FRESNO ST STE 106
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93726-4031
Practice Address - Country:US
Practice Address - Phone:559-354-0340
Practice Address - Fax:559-354-0341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-10
Last Update Date:2021-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332S00000XSuppliersHearing Aid Equipment