| Healing Grove Health Center Inc., A Social Purpose Corporation | |
|
226 W Alma Ave Ste 10 San Jose CA 95110-3520 | |
| (408) 583-6338 | |
| (408) 516-1154 |
| Full Name | Healing Grove Health Center Inc., A Social Purpose Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 226 W Alma Ave Ste 10, San Jose, California |
| Authorized Official Name and Position | Cheryl June Ho Thieu (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4083986318 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Grove Health Center Inc., A Social Purpose Corporation 448 Goodyear St San Jose CA 95110-3201 Ph: (408) 583-6338 | Healing Grove Health Center Inc., A Social Purpose Corporation 226 W Alma Ave Ste 10 San Jose CA 95110-3520 Ph: (408) 583-6338 |
| NPI Number | 1205465747 |
|---|---|
| Provider Enumeration Date | 04/06/2020 |
| Last Update Date | 04/06/2020 |
| Medicare PECOS PAC ID | 9032538988 |
|---|---|
| Medicare Enrollment ID | O20200928000792 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205465747 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Angela Jo Bymaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437392263 PECOS PAC ID: 9638223803 Enrollment ID: I20090822000045 |
| Provider Name | Cheryl June Ho Thieu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528022357 PECOS PAC ID: 5799840542 Enrollment ID: I20150826001154 |
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