# GOLDEN STATE EYE MEDICAL GROUP INC

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

## Provider details

- **NPI number:** 1205847746
- **Authorized official:** KHALED A TAWANSY M.D (OWNER)
- **Authorized official phone:** (661) 327-4499

## Contact information

- **Practice address:** 6000 PHYSICIANS BLVD BUILDING D, SUITE 205, BAKERSFIELD, CA 93301-5840
- **Practice address phone:** (661) 327-4499
- **Practice address fax:** (661) 327-4381
- **Mailing address:** 6000 PHYSICIANS BLVD BLDG D, BAKERSFIELD, CA 93301-5840
- **Mailing address phone:** (661) 327-4499
- **Mailing address fax:** (661) 327-4381

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 152W00000X | Optometrist | 13086T | CA | — |
| 156FX1800X | Optician | — | NULL | — |
| 156FX1800X | Optician | — | — | — |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 208600000X | Surgery Physician | G30637 | CA | — |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 10/23/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 180012319 | MEDICARE RAILROAD | CA |