Golden State Providers
ActiveCalifornia license 558333
License
- Licensed by
- Medical Board of California
- License number
- 558333
- Status
- Active (Current)
- First issued
- October 16, 2024
- Expires
- October 31, 2028
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
855 Patriot Dr # 203
Moorpark, CA 93021
Moorpark, CA 93021
Ventura County