Organization
GOLDENWEST MEDICAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEANNIE AGEMA (OWNER)
(949) 583-0937
Entity
Organization
Contact information
Practice address
25422 TRABUCO RD, STE 105-622, LAKE FOREST, CA 92630-2791
(949) 583-0937
(949) 583-0939
Mailing address
25422 TRABUCO RD, STE 105-622, LAKE FOREST, CA 92630-2791
(949) 583-0937
(949) 583-0939
Taxonomy
Speciality
Code
Description
License number
State
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Enumeration date
01/27/2011
Last updated
01/27/2011
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