Golden State Primary Care Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

GOLDEN STATE PRIMARY CARE INC

Practice address

16465 Sierra Lakes Pkwy Ste 115
Fontana, CA 92336-1242

Phone

(909) 823-8000

Fax

(909) 823-8088

NPI assigned

Jan 15, 2026

Organization subpart

No

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

Authorized official

Name

Namita Mohideen, MDNPI 1871543850

Title

Ceo

Phone

(909) 823-8000

Specialties & licenses 5

Addresses

Locations

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Namita P. Mohideen, M.D.

  • Pediatrics Physician
  • Fontana, CA
  • NPI 1871543850
  NPD (past) Authorized official
• Butool Saba Abdullah, MD

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1285130708
  NPD (past)
• Jose I Arciniega, D.O.

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1265642052
  NPD (past)
• Marcus Anthony Barber, MD

  • Pediatrics Physician
  • Victorville, CA
  • NPI 1891766333
  NPD (past)
• Ray Tojino Bobila, MD

  • Pediatrics Physician
  • Victorville, CA
  • NPI 1710977160
  NPD (past)
• Ashly Patricia Cameron, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Apple Valley, CA
  • NPI 1033005749
  NPD (past)
• Jay Chae, NP

  • Family Nurse Practitioner
  • Redlands, CA
  • NPI 1275237422
  NPD (past)
• Decerie Baculi Dayag, MD

  • Internal Medicine Physician
  • Upland, CA
  • NPI 1336660901

  Multi-Specialty

  NPD (past)
• Tarathya Bunga Dharmasaputra, MD

  • Pediatrics Physician
  • Victorville, CA
  • NPI 1093387672
  NPD (past)
• Cinthya Flores Sigala, CHW

  • Community Health Worker
  • Fontana, CA
  • NPI 1649097932
  NPD (past)
• Xu Long He, D.O

  • Internal Medicine Physician
  • Fontana, CA
  • NPI 1568773448
  NPD (past)
• Maged Fayez Ibrahim, M.D.

  • Pediatrics Physician
  • Fontana, CA
  • NPI 1306852934
  NPD (past)

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

{
    "created_epoch": "1768435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768435200000",
    "number": "1124987201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 115",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-823-8000",
            "fax_number": "909-823-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16465 SIERRA LAKES PKWY STE 115",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923361242",
            "telephone_number": "909-823-8000",
            "fax_number": "909-823-8088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4240 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Highland",
            "state": "CA",
            "postal_code": "923462764",
            "country_code": "US",
            "telephone_number": "909-674-1900",
            "fax_number": "909-735-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15237 Eleventh St Ste C",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923953736",
            "country_code": "US",
            "telephone_number": "760-493-9300",
            "fax_number": "760-493-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 E 11th St Ste 208",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864872",
            "country_code": "US",
            "telephone_number": "909-493-7410",
            "fax_number": "909-766-9410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 N Waterman Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924044811",
            "country_code": "US",
            "telephone_number": "909-674-1600",
            "fax_number": "909-674-1800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "603 E Latham Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925434342",
            "country_code": "US",
            "telephone_number": "951-502-3500",
            "fax_number": "951-502-3400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 E 11th St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Upland",
            "state": "CA",
            "postal_code": "917864872",
            "country_code": "US",
            "telephone_number": "909-985-0883",
            "fax_number": "909-985-5762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16854 Ivy Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923351504",
            "country_code": "US",
            "telephone_number": "909-791-1000",
            "fax_number": "909-781-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1684 Plum Ln Ste 101",
            "address_purpose": "LOCATION",
            "city": "Redlands",
            "state": "CA",
            "postal_code": "923742866",
            "country_code": "US",
            "telephone_number": "909-798-5599",
            "fax_number": "909-798-5595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18523 Corwin Rd Ste H",
            "address_purpose": "LOCATION",
            "city": "Apple Valley",
            "state": "CA",
            "postal_code": "923072300",
            "country_code": "US",
            "telephone_number": "760-242-3005",
            "fax_number": "760-503-1375",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "15237 Eleventh St Ste A",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923953736",
            "country_code": "US",
            "telephone_number": "760-662-7420",
            "fax_number": "760-513-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GOLDEN STATE PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-15",
        "last_updated": "2026-01-15",
        "certification_date": "2026-01-15",
        "status": "A",
        "authorized_official_last_name": "MOHIDEEN",
        "authorized_official_first_name": "NAMITA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "909-823-8000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anthony Mena Gobran, MD
• Anthony Godlewski, PHARM. D.
• Ana Vargas Godoy, D.D.S.
• Jacek F. Gogolok, MD
• Gold Star Medical Transport Inc.
• Todd Goldenberg, MD
• Goldstar Pediatrics PC
• Alonzo Gomez, RRT, RPSGT
• Christina Renee Gomez
• Jonathan Vinicio Gomez

• General Practice Physician in Fontana, CA
• Providers in Fontana, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.