Provider Demographics
NPI:1801499983
Name:GOLDEN EGG ACUPUNCTURE, INC.
Entity type:Organization
Organization Name:GOLDEN EGG ACUPUNCTURE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:COLER
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:DAOM
Authorized Official - Phone:310-488-2790
Mailing Address - Street 1:2405 34TH ST UNIT 25
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-2149
Mailing Address - Country:US
Mailing Address - Phone:310-488-2790
Mailing Address - Fax:
Practice Address - Street 1:12655 W WASHINGTON BLVD STE 106
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-2399
Practice Address - Country:US
Practice Address - Phone:310-943-9044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Single Specialty