| Organization Name: | SOUTH COUNTY COMMUNITY HEALTH CENTER, INC. |
| NPI Number: | 1073640918 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | WAYNE YOST (CHIEF FINANCIAL OFFICER) |
| Mailing Address: | 100 Terminal Ave Menlo Park |
| State: | CA US |
| Postal Code: | 940251246 |
| Phone Number: | 6503210980 |
| Fax Number: | 6503210988 |
| NPI Enumeration Date: | 02/27/2007 |
| NPI Last Update Date: | 10/01/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |