Organization
GOLDEN STATE PRIMARY CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAMITA MOHIDEEN MD (CEO)
(909) 823-8000
Entity
Organization
Contact information
Practice address
16465 SIERRA LAKES PKWY STE 115, FONTANA, CA 92336-1242
(909) 823-8000
(909) 823-8088
Mailing address
16465 SIERRA LAKES PKWY STE 115, FONTANA, CA 92336-1242
(909) 823-8000
(909) 823-8088
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
01/15/2026
Last updated
01/15/2026
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