Graduated: 1993
NPI: 1710989439
Practice Locations (2)
GOLDEN STATE PROVIDERS, A MEDICAL CORPORATION
215 W JANSS RD
THOUSAND OAKS, CA 913601847
8058529100
GOLDEN STATE PROVIDERS, A MEDICAL CORPORATION
227 W JANSS RD, SUITE 340
THOUSAND OAKS, CA 913601879
8058529100
Source: CMS National Downloadable File, September 2026.