NPIMap

Organization Active NPI

Golden State Medical Group

  • Family Medicine Physician
  • Montclair, CA
National Provider Identifier
1255958476
Registry record updated Jul 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GOLDEN STATE MEDICAL GROUP
Practice address
4959 Palo Verde St Ste 206a-5
Montclair, CA 91763-2342
Phone
(909) 694-4016
Fax
(909) 920-3344
NPI assigned
Jul 3, 2020
Last updated
Jul 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2020

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

Authorized official

Name
Dr. Jhujhar Singh, DONPI 1730361544
Title
Physician/Owener
Phone
(909) 694-4016

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

4959 Palo Verde St Ste 206a-5
Montclair, CA 91763-2342

Mailing address

4959 Palo Verde St Ste 206a-5
Montclair, CA 91763-2342
Phone (909) 694-4016

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210330000883 CA Part B Supplier - Clinic/Group Practice 0042622441 Receives reassigned benefits from 10 practitioners
Practice locations: Montclair, CA; San Dimas, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

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 17

NPI Registry JSON

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

{
    "created_epoch": "1593734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593734400000",
    "number": "1255958476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 PALO VERDE ST STE 206A-5",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632342",
            "telephone_number": "909-694-4016",
            "fax_number": "909-920-3344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4959 PALO VERDE ST STE 206A-5",
            "city": "MONTCLAIR",
            "state": "CA",
            "postal_code": "917632342",
            "telephone_number": "909-694-4016",
            "fax_number": "909-920-3344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN STATE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-03",
        "last_updated": "2020-07-03",
        "certification_date": "2020-07-03",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "JHUJHAR",
        "authorized_official_title_or_position": "PHYSICIAN/OWENER",
        "authorized_official_telephone_number": "909-694-4016",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2020; 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.