Organization
GOLDEN YEARS MEDICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE NAIKER (CEO)
(415) 453-6500
Entity
Organization
Contact information
Practice address
625 DU BOIS ST, SUITE C, SAN RAFAEL, CA 94901-3944
(415) 453-6500
(415) 453-6505
Mailing address
625 DU BOIS ST, SUITE C, SAN RAFAEL, CA 94901-3944
(415) 453-6500
(415) 453-6505
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
070592001
CA
332BC3200X
Customized Equipment (DME)
8531
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DME01000F
—
CA
Enumeration date
08/02/2005
Last updated
06/06/2012
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