| Golden State Medical Group | |
|
4959 Palo Verde St Ste 206a-5 Montclair CA 91763-2342 | |
| (909) 694-4016 | |
| (909) 920-3344 |
| Full Name | Golden State Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 4959 Palo Verde St Ste 206a-5, Montclair, California |
| Authorized Official Name and Position | Jhujhar Singh (PHYSICIAN/OWENER) |
| Authorized Official Contact | 9096944016 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden State Medical Group 4959 Palo Verde St Ste 206a-5 Montclair CA 91763-2342 Ph: (909) 694-4016 | Golden State Medical Group 4959 Palo Verde St Ste 206a-5 Montclair CA 91763-2342 Ph: (909) 694-4016 |
| NPI Number | 1255958476 |
|---|---|
| Provider Enumeration Date | 07/03/2020 |
| Last Update Date | 07/03/2020 |
| Certification Date | 07/03/2020 |
| Medicare PECOS PAC ID | 0042622441 |
|---|---|
| Medicare Enrollment ID | O20210330000883 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255958476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| Provider Name | Jhujhar Singh |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1730361544 PECOS PAC ID: 1254418817 Enrollment ID: I20080407000241 |
| Provider Name | Andrea L Glover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962976019 PECOS PAC ID: 7214277656 Enrollment ID: I20190320003000 |
| Provider Name | Edward Tsung Lin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881122315 PECOS PAC ID: 1658608823 Enrollment ID: I20190809002395 |
| Provider Name | Wenbai Zhou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841644143 PECOS PAC ID: 9638409196 Enrollment ID: I20190925002922 |
| Provider Name | Sushma Sadula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104489566 PECOS PAC ID: 0244659241 Enrollment ID: I20200924001048 |
| Provider Name | Jose Fernando Velasquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053897561 PECOS PAC ID: 7517369804 Enrollment ID: I20210708002967 |
| Provider Name | Sachin Kumar Chatta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063906709 PECOS PAC ID: 6002205929 Enrollment ID: I20211116000701 |
| Provider Name | Ragu Sivarajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902246523 PECOS PAC ID: 5991087942 Enrollment ID: I20220705001570 |
| Provider Name | Narinder Singh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841867439 PECOS PAC ID: 8325410996 Enrollment ID: I20230207003345 |
| Provider Name | Harikrishna Ambati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154998730 PECOS PAC ID: 5890168850 Enrollment ID: I20230222002936 |
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