| Organization Name: | SOUTH COUNTY COMMUNITY HEALTH CENTER, INC. |
| NPI Number: | 1245695881 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LUISA BUADA (CEO) |
| Mailing Address: | 1885 Bay Rd East Palo Alto |
| State: | CA US |
| Postal Code: | 943031312 |
| Phone Number: | 6503307400 |
| Fax Number: | 6503211560 |
| NPI Enumeration Date: | 12/28/2015 |
| NPI Last Update Date: | 02/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | PHY53775 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |