Organization Active NPI

Golden State Adult Day Health Care Inc

  • Adult Day Care Clinic/Center
  • San Francisco, CA
National Provider Identifier
1215140843
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Day Care Clinic/CenterTaxonomy code 261QA0600X
Legal business name
GOLDEN STATE ADULT DAY HEALTH CARE INC
Practice address
738 La Playa St
San Francisco, CA 94121-3262
Phone
(451) 387-2750
Fax
(415) 387-2712
NPI assigned
May 8, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Dmitry Margusov, D.C.
Title
Administrator
Phone
(415) 387-2750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X CA Primary

Addresses

Primary practice location

738 La Playa St
San Francisco, CA 94121-3262

Mailing address

738 La Playa St
San Francisco, CA 94121-3262
Phone (451) 387-2750

Other identifiers 1

IdentifierTypeStateIssuer
ADU70287FMedicaidCA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D1004380Golden State Adult Day Health Care738 La Playa Street, San Francisco, CA 94121Certificate of waiverSep 24, 2026

National Provider Directory

National Provider Directory

Locations

738 La Playa St
San Francisco, CA 94121
Phone (415) 387-2750

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1215140843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 LA PLAYA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941213262",
            "telephone_number": "451-387-2750",
            "fax_number": "415-387-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "738 LA PLAYA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941213262",
            "telephone_number": "451-387-2750",
            "fax_number": "415-387-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN STATE ADULT DAY HEALTH CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MARGUSOV",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "415-387-2750",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ADU70287F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.