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3351 El Camino Real Suite 100 Atherton CA 94027-3811 | |
(408) 200-2291 | |
(408) 278-7799 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3351 El Camino Real, Atherton, California |
Authorized Official Name and Position | Ofelia Ruiz (DIRECTOR) |
Authorized Official Contact | 4089353971 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1621 Gold Street Alviso CA 95002-1240 Ph: (408) 200-2291 | 3351 El Camino Real Suite 100 Atherton CA 94027-3811 Ph: (408) 200-2291 |
NPI Number | 1922366186 |
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Provider Enumeration Date | 04/25/2012 |
Last Update Date | 08/22/2017 |
Medicare PECOS PAC ID | 5890859375 |
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Medicare Enrollment ID | O20170823002264 |
Identifier | Type | State | Issuer |
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1922366186 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |