| Goldencast Medical Corporation | |
|
929 S Bedford St Suite 301 Los Angeles CA 90035-1989 | |
| (626) 442-5200 | |
| (866) 931-3134 |
| Full Name | Goldencast Medical Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 929 S Bedford St, Los Angeles, California |
| Authorized Official Name and Position | Shahriar Jarchi (PRESIDENT) |
| Authorized Official Contact | 6267654321 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Goldencast Medical Corporation 929 S Bedford St Suite 301 Los Angeles CA 90035-1989 Ph: (626) 765-4302 | Goldencast Medical Corporation 929 S Bedford St Suite 301 Los Angeles CA 90035-1989 Ph: (626) 442-5200 |
| NPI Number | 1952550097 |
|---|---|
| Provider Enumeration Date | 09/12/2008 |
| Last Update Date | 04/02/2024 |
| Medicare PECOS PAC ID | 3678620176 |
|---|---|
| Medicare Enrollment ID | O20090421000419 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952550097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A96880 (California) | Primary |
| Provider Name | David Hayden Skinner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265489678 PECOS PAC ID: 0042278350 Enrollment ID: I20050103000445 |
| Provider Name | Shahriar Jarchi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417008772 PECOS PAC ID: 2062594310 Enrollment ID: I20080125000506 |
| Provider Name | Samuel Sang-bum Nam |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1396936951 PECOS PAC ID: 5294904124 Enrollment ID: I20110811000183 |
| Provider Name | Rishi Gupta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922208982 PECOS PAC ID: 9537327861 Enrollment ID: I20120216000126 |
| Provider Name | Venessa Emma Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437781283 PECOS PAC ID: 2961829932 Enrollment ID: I20200907000033 |
| Provider Name | Merian M Apolinario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881347516 PECOS PAC ID: 5092194993 Enrollment ID: I20220623002227 |
| Provider Name | Mary Joy Mendoza Caritos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871208009 PECOS PAC ID: 6002273380 Enrollment ID: I20230531003186 |
| Provider Name | Salve Romasanta Bautista |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518247188 PECOS PAC ID: 3072049386 Enrollment ID: I20241210004065 |
| Provider Name | Jennifer Destreza Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447806021 PECOS PAC ID: 7618404856 Enrollment ID: I20241230000455 |
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