| Organization Name: | GOLDEN EAR MEDICAL GROUP, INC |
| NPI Number: | 1760408256 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | GARY EUGENE FORD (MEDICAL DIRECTOR) |
| Mailing Address: | 1045 W Redondo Beach Blvd Suite 575 Gardena |
| State: | CA US |
| Postal Code: | 902474128 |
| Phone Number: | 3103298633 |
| Fax Number: | 3103298636 |
| NPI Enumeration Date: | 07/15/2006 |
| NPI Last Update Date: | 10/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | G36302 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |