Provider Demographics
NPI:1528883055
Name:GOLDEN OAK DERMATOLOGY, P.C.
Entity type:Organization
Organization Name:GOLDEN OAK DERMATOLOGY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONNY
Authorized Official - Middle Name:C
Authorized Official - Last Name:CHOE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:661-380-7751
Mailing Address - Street 1:24307 MAGIC MOUNTAIN PKWY STE 313
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355-3402
Mailing Address - Country:US
Mailing Address - Phone:661-380-7751
Mailing Address - Fax:
Practice Address - Street 1:23823 VALENCIA BLVD STE 150
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-9509
Practice Address - Country:US
Practice Address - Phone:661-380-7751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty