# GOLDEN STATE MEDICAL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194717520
- **Authorized official:** MR. SCOTT GRAVES (CEO)
- **Authorized official phone:** (800) 696-2900

## Contact information

- **Practice address:** 200 LINDEN AVE, 100, AUBURN, CA 95603-5280
- **Practice address phone:** (800) 696-2900
- **Practice address fax:** (530) 885-3631
- **Mailing address:** PO BOX 300, AUBURN, CA 95604-0300
- **Mailing address phone:** (800) 696-2900
- **Mailing address fax:** (530) 885-3631

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |
| 335E00000X | Prosthetic/Orthotic Supplier | CO2725 | CA | — |

## Other

- **Enumeration date:** 08/22/2005
- **Last updated:** 06/21/2021