NPIMap

Organization Active NPI

Golden State Orthopedics & Spine

  • Orthopaedic Surgery Physician
  • Oakland, CA
National Provider Identifier
1093307746
Registry record updated Jan 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
GOLDEN STATE ORTHOPEDICS & SPINE
Practice address
80 Grand Ave Ste 600
Oakland, CA 94612-3744
Phone
(925) 939-8585
NPI assigned
Feb 4, 2021
Last updated
Jan 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GOLDEN STATE ORTHOPEDICS & SPINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
K.C. Campion
Title
Ceo
Phone
(925) 210-8573

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X Primary

Addresses

Primary practice location

80 Grand Ave Ste 600
Oakland, CA 94612-3744

Mailing address

PO Box 31396
Walnut Creek, CA 94598-8396
Phone (925) 939-8585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000721 CA Part B Supplier - Clinic/Group Practice 8224940739 Receives reassigned benefits from 275 practitioners
21 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Oakland, CA; San Francisco, CA; San Jose, CA; San Ramon, CA; Santa Clara, CA; Walnut Creek, CA; Watsonville, CA; Mountain View, CA…

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 21

National Provider Directory

National Provider Directory
Part of
Muir Orthopaedic Specia

Practitioners & affiliated clinicians

Practitioners 27

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 27

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1612396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643155200000",
    "number": "1093307746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31396",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945988396",
            "telephone_number": "925-939-8585",
            "fax_number": "925-933-2709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GRAND AVE STE 600",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946123744",
            "telephone_number": "925-939-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN STATE ORTHOPEDICS & SPINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOLDEN STATE ORTHOPEDICS & SPINE",
        "enumeration_date": "2021-02-04",
        "last_updated": "2022-01-26",
        "certification_date": "2022-01-26",
        "status": "A",
        "authorized_official_last_name": "CAMPION",
        "authorized_official_first_name": "K.C.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "925-210-8573"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.