Organization
GOLDEN STATE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT GRAVES (CEO)
(800) 696-2900
Entity
Organization
Contact information
Practice address
200 LINDEN AVE, 100, AUBURN, CA 95603-5280
(800) 696-2900
(530) 885-3631
Mailing address
PO BOX 300, AUBURN, CA 95604-0300
(800) 696-2900
(530) 885-3631
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
335E00000X
Prosthetic/Orthotic Supplier
CO2725
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01705F
—
CA
Enumeration date
08/22/2005
Last updated
06/21/2021
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