Organization
GOLDEN STATE PHYSICIANS MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GORDON WONG M.D. (PRESIDENT OF THE BOARD)
(530) 271-3200
Entity
Organization
Contact information
Practice address
900 E MAIN ST STE 301, GRASS VALLEY, CA 95945-5853
(530) 271-3200
(530) 274-6347
Mailing address
900 E MAIN ST STE 301, GRASS VALLEY, CA 95945-5853
(530) 271-3200
(530) 274-6347
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
08/22/2020
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