# GOLDENWEST MEDICAL SERVICES, LLC

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

## Provider details

- **NPI number:** 1578869376
- **Authorized official:** MRS. JEANNIE AGEMA (OWNER)
- **Authorized official phone:** (949) 583-0937

## Contact information

- **Practice address:** 25422 TRABUCO RD, STE 105-622, LAKE FOREST, CA 92630-2791
- **Practice address phone:** (949) 583-0937
- **Practice address fax:** (949) 583-0939
- **Mailing address:** 25422 TRABUCO RD, STE 105-622, LAKE FOREST, CA 92630-2791
- **Mailing address phone:** (949) 583-0937
- **Mailing address fax:** (949) 583-0939

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | NULL | Yes |
| 2083P0901X | Public Health & General Preventive Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/27/2011
- **Last updated:** 01/27/2011