Golden State Family Clinic

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GOLDEN STATE FAMILY CLINIC

Practice address

4082 Whittier Blvd Ste 102
Los Angeles, CA 90023-2559

Phone

(323) 347-5757

Fax

(323) 264-2671

NPI assigned

Oct 13, 2023

Organization subpart

No

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

Authorized official

Name

Harold Tabaie, DONPI 1346286663

Title

Ceo

Phone

(941) 720-0731

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Golden State Family Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Golden State Family Clinic

  • Internal Medicine Physician
  • Anaheim, CA
  • NPI 1124839139
  NPD tax ID

Locations

Practitioners 3

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

• Harold A Tabaie, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Los Angeles, CA
  • NPI 1346286663
  Medicare reassignment Care Compare group NPD Authorized official
• John I Sam, MD

  • Internal Medicine Physician
  • Los Angeles, CA
  • NPI 1033278031
  Medicare reassignment Care Compare group NPD
• Alfred Lawrence Glover, DPM

  • Podiatrist
  • Inglewood, CA
  • NPI 1205981859
  Medicare reassignment NPD

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

{
    "created_epoch": "1697155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697155200000",
    "number": "1578345625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18025",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928178025",
            "telephone_number": "941-720-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4082 WHITTIER BLVD STE 102",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232559",
            "telephone_number": "323-347-5757",
            "fax_number": "323-264-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN STATE FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-13",
        "last_updated": "2023-10-13",
        "certification_date": "2023-10-13",
        "status": "A",
        "authorized_official_last_name": "TABAIE",
        "authorized_official_first_name": "HAROLD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "941-720-0731",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "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": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Golden Phase Acupuncture Co. (Golden Phase)
• Golden Rule Home Health, Inc.
• Golden Seal Home Health, Inc
• Golden Star Labs LLC
• Golden State Emergency Physicians Inc
• Golden State Home Care Inc
• Golden State Homes, Inc.
• Golden State Integrative Health, Naturopathic PC (Golden State Integrative Health)
• Golden State Recuperative Care, Inc.
• Golden State Rehab LLC

• Internal Medicine Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2023; 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.