Provider Demographics
NPI:1962764340
Name:GOLDEN ARDAYA & LIN OPTOMETRY INC
Entity type:Organization
Organization Name:GOLDEN ARDAYA & LIN OPTOMETRY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOLDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:562-692-1208
Mailing Address - Street 1:11245 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-3111
Mailing Address - Country:US
Mailing Address - Phone:562-692-1208
Mailing Address - Fax:562-695-6386
Practice Address - Street 1:11245 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-3111
Practice Address - Country:US
Practice Address - Phone:562-692-1208
Practice Address - Fax:562-695-6386
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-12
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGE638AMedicare PIN