Organization
GOLDEN STATE EYE MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALED A TAWANSY M.D (OWNER)
(661) 327-4499
Entity
Organization
Contact information
Practice address
6000 PHYSICIANS BLVD BUILDING D, SUITE 205, BAKERSFIELD, CA 93301-5840
(661) 327-4499
(661) 327-4381
Mailing address
6000 PHYSICIANS BLVD BLDG D, BAKERSFIELD, CA 93301-5840
(661) 327-4499
(661) 327-4381
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
13086T
CA
156FX1800X
Optician
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
208600000X
Surgery Physician
G30637
CA
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180012319
MEDICARE RAILROAD
CA
Enumeration date
08/10/2006
Last updated
10/23/2025
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