N/a | |
871 Enborg Ct Unit 100 San Jose CA 95128-2645 | |
(408) 885-7855 | |
Not Available |
Full Name | N/a |
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Speciality | Psychiatric Unit |
Location | 871 Enborg Ct Unit 100, San Jose, California |
Authorized Official Name and Position | Margaret Obilor (PROGRAM MANAGER) |
Authorized Official Contact | 4087932055 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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N/a 871 Enborg Ct Unit 100 San Jose CA 95128-2645 Ph: (408) 885-7855 | N/a 871 Enborg Ct Unit 100 San Jose CA 95128-2645 Ph: (408) 885-7855 |
NPI Number | 1265736342 |
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Provider Enumeration Date | 01/04/2011 |
Last Update Date | 01/04/2011 |
Identifier | Type | State | Issuer |
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1265736342 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
273R00000X | Psychiatric Unit | LCS26815 (California) | Primary |
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