| Golden Rose Pgx LLC | |
|
4070 Baseline Rd Ste 110 Roseville CA 95747-6489 | |
| (925) 339-5826 | |
| (916) 403-7198 |
| Full Name | Golden Rose Pgx LLC |
|---|---|
| Speciality | Clinic/center |
| Location | 4070 Baseline Rd Ste 110, Roseville, California |
| Authorized Official Name and Position | Fariba Clapper (PRESIDENT) |
| Authorized Official Contact | 9253395826 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Rose Pgx LLC 4148 Sally Ride Way Sacramento CA 95834-4001 Ph: (925) 339-5826 | Golden Rose Pgx LLC 4070 Baseline Rd Ste 110 Roseville CA 95747-6489 Ph: (925) 339-5826 |
| NPI Number | 1902613805 |
|---|---|
| Provider Enumeration Date | 12/13/2024 |
| Last Update Date | 12/18/2024 |
| Certification Date | 12/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902613805 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
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