Organization Active NPI

Golden Rose PGX LLC

  • Clinic/Center
  • Roseville, CA
National Provider Identifier
1902613805
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GOLDEN ROSE PGX LLC
Doing business as
Golden Rose PGX LLC
Practice address
4070 Baseline Rd Ste 110
Roseville, CA 95747-6489
Phone
(925) 339-5826
Fax
(916) 403-7198
NPI assigned
Dec 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Fariba ClapperNPI 1073081840
Title
President
Phone
(925) 339-5826

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

4070 Baseline Rd Ste 110
Roseville, CA 95747-6489

Mailing address

4148 Sally Ride Way
Sacramento, CA 95834-4001
Phone (925) 339-5826

Other names 1

  • Golden Rose PGX LLC Doing business as

National Provider Directory

National Provider Directory

Locations

4070 Baseline Rd
Ste 110
Roseville, CA 95747
Phone (916) 572-1155

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1734048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1902613805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4148 SALLY RIDE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958344001",
            "telephone_number": "925-339-5826",
            "fax_number": "916-403-7198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 BASELINE RD STE 110",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "957476489",
            "telephone_number": "925-339-5826",
            "fax_number": "916-403-7198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLDEN ROSE PGX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-13",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "CLAPPER",
        "authorized_official_first_name": "FARIBA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "925-339-5826"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Golden Rose PGX LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Golden Rose PGX LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.