Organization Name: | SOUTH COUNTY COMMUNITY HEALTH CENTER INC. |
NPI Number: | 1376697482 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WAYNE YOST (CHIEF FINANCIAL OFFICER) |
Mailing Address: | 1798 Bay Rd # A East Palo Alto |
State: | CA US |
Postal Code: | 943031611 |
Phone Number: | 6503307400 |
Fax Number: | 6503211156 |
NPI Enumeration Date: | 01/23/2007 |
NPI Last Update Date: | 06/11/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 05245 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |