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Organization
GOLDEN EAGLE
Active
Organization
GOLDEN EAGLE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADELLA CORDOVA (MEDICAL BILLER)
(623) 326-1055
Entity
Organization
Contact information
Practice address
14 MONARCH BAY PLZ, MONARCH BEACH, CA 92629-3467
(949) 444-3966
Mailing address
14 MONARCH BAY PLZ, MONARCH BEACH, CA 92629-3467
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
CA
Other
Enumeration date
03/15/2018
Last updated
03/10/2021
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