# GOLDEN STATE FAMILY CLINIC

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

## Provider details

- **NPI number:** 1578345625
- **Authorized official:** HAROLD TABAIE DO (CEO)
- **Authorized official phone:** (941) 720-0731

## Contact information

- **Practice address:** 4082 WHITTIER BLVD STE 102, LOS ANGELES, CA 90023-2559
- **Practice address phone:** (323) 347-5757
- **Practice address fax:** (323) 264-2671
- **Mailing address:** PO BOX 18025, ANAHEIM, CA 92817-8025
- **Mailing address phone:** (941) 720-0731

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/13/2023
- **Last updated:** 10/13/2023