Organization Name: | OTOLOGY SURGERY CENTER |
NPI Number: | 1285920132 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LYDIA BLEVINS (BUSINESS OFFICE DIRECTOR) |
Mailing Address: | 1900 University Ave Ste 101 East Palo Alto |
State: | CA US |
Postal Code: | 943032213 |
Phone Number: | 6504941000 |
Fax Number: | |
NPI Enumeration Date: | 06/20/2011 |
NPI Last Update Date: | 06/20/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QA1903X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Ambulatory Surgical |
Taxonomy Definition: |