GOLDENWEST MEDICAL SERVICES, LLC (NPI# 1578869376) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578869376 |
| Entity Type | Organization |
| Organization Name | GOLDENWEST MEDICAL SERVICES, LLC |
| Practice Address |
25422 Trabuco Rd Ste 105-622 Lake Forest CA 92630-2791 |
| Practice Telephone | 9495830937 |
| Practice Fax Number | 9495830939 |
| Mailing Telephone | 9495830937 |
| Mailing Fax Number | 9495830939 |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2011-01-27 |
| Authorized Official Name | MRS. JEANNIE AGEMA (OWNER) |
| Authorized Official Telephone | 9495830937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | GOLDENWEST MEDICAL SERVICES, LLC | 3160 Hillview Dr N, Chino, CA 91710 |
| Colorado Business Entities | Goldenwest Medical Services, LLC | 3160 Hillview Dr. N, Chino, CA 91710 |
| Washington State Corporations | GOLDENWEST MEDICAL SERVICES, LLC | 3160 Hillview Dr N, Chino, CA 91710-2939 |
| Street Address |
25422 TRABUCO RD STE 105-622 |
| City | LAKE FOREST |
| State | CA |
| Zip Code | 92630-2791 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669698361 | Gary Paul Jones | Dentist | 25422 Trabuco Rd, Suite 104, Lake Forest, CA 92630-2791 | 2007-04-18 |
| 1902249949 | Nova M Reed | Counselor | 25422 Trabuco Rd, Suite 105-366, Lake Forest, CA 92630-2791 | 2013-04-09 |
| 1548511470 | Mika Diagnostic Services | Clinic/Center | 25422 Trabuco Rd, Ste 105-623, Lake Forest, CA 92630-2791 | 2012-10-02 |
| 1457683906 | The H5 Premier Group. Dba Ca Caring Connection | In Home Supportive Care | 25422 Trabuco Rd, 105-632, Lake Forest, CA 92630-2791 | 2010-02-09 |
| 1164674909 | Chabonik Sweet | Speech-Language Pathologist | 25422 Trabuco Rd, Suite 105, Lake Forest, CA 92630-2791 | 2008-10-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194370338 | Ashlee Nicole-morton Sourapas | Midwife | 22672 Lambert Street, Suite 611, Lake Forest, CA 92630 | 2019-08-05 |
| 1134784879 | Scott Mach Enterprises | Custodial Care Facility | 23235 Cavanaugh Road, Lake Forest, CA 92630 | 2019-05-08 |
| 1992368930 | James Daniel Ticorat | Pharmacist | 25051 Calle Arenal, Lake Forest, CA 92630 | 2019-04-16 |
| 1770058349 | Tara L Anderson | Physician Assistant | 22365 El Toro Rd Unit 310, Lake Forest, CA 92630 | 2018-10-10 |
| 1659846855 | Song W. Jung. Dds. Inc | Dentist | 23361 El Toro Rd, Ste 105, Lake Forest, CA 92630 | 2018-10-04 |
| 1326520867 | Katherine Marie Billings | Speech-Language Pathologist | 25454 Navajo, Lake Forest, CA 92630 | 2018-08-31 |
| 1205339611 | Orange County Physiotherapy Services, P.C. | Physical Therapist | 22821 Aspan St., #100, Lake Forest, CA 92630 | 2018-03-12 |
| 1295245587 | Tara Rasta | Chiropractor | 22672 Lambert St Suite 620, Olsen Chiropractic, Lake Forest, CA 92630 | 2017-10-02 |
| 1750800132 | Jessica Aguilar | Marriage & Family Therapist | 21153 Calle De Paseo, Lake Forest, CA 92630 | 2017-09-16 |
| 1275072589 | Anhtu Wu | Pharmacist | 23182 Vista Way, Lake Forest, CA 92630 | 2017-02-20 |
| Find all providers in zip 92630 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
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|---|---|---|---|---|
| 1710592126 | Best Healthcare Access | Preventive Medicine | 3218 E Holt Ave Ste 201a, West Covina, CA 91791-2310 | 2020-09-11 |
| 1134739642 | Wellcentrex LLC | Preventive Medicine | 4590 Macarthur Blvd Ste 500, Newport Beach, CA 92660-2028 | 2020-08-10 |
| 1548870926 | Sofia Lucha Robles Castillo | Preventive Medicine | 9616 Micron Ave Ste 670, Sacramento, CA 95827-2699 | 2020-07-31 |
| 1972124485 | Douglas L Hatch | Preventive Medicine | 680 Talbot Ave, Pacifica, CA 94044-2650 | 2020-05-06 |
| 1154959138 | Jaime Renee Reise | Preventive Medicine | 8358 Santa Monica Blvd, West Hollywood, CA 90069-4313 | 2020-03-27 |
| 1861024515 | Another Way 2 LLC | Preventive Medicine | 3840 Lemon St, Riverside, CA 92501-3693 | 2020-02-11 |
| 1275186793 | Thinknetic Medical Corporation | Preventive Medicine | 1950 S Sunwest Ln Ste 108, San Bernardino, CA 92408-3263 | 2019-07-23 |
| 1396306650 | Ankush Raj Gaur | Preventive Medicine | 21303 Oakriver Ln, Newhall, CA 91321-4679 | 2019-06-26 |
| 1982167565 | Kristina Deguzman | Preventive Medicine | 9616 Micron Ave Ste 970, Sacramento, CA 95827-2627 | 2019-04-10 |
| 1760940902 | Taby Corp. | Preventive Medicine | 73710 Alessandro Dr Ste A1, Palm Desert, CA 92260-3638 | 2019-03-06 |
| Find all providers with the same taxonomy | ||||
| City | LAKE FOREST |
| Zip Code | 92630 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.