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665 S Knickerbocker Dr Ste 3 Sunnyvale CA 94087-1059 | |
| (408) 774-9887 | |
| (408) 736-6656 |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 665 S Knickerbocker Dr Ste 3, Sunnyvale, California |
| Authorized Official Name and Position | Larry Charles Gans (OWNER/CEO) |
| Authorized Official Contact | 4087749887 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
665 S Knickerbocker Dr Ste 3 Sunnyvale CA 94087-1059 Ph: (408) 774-9887 | 665 S Knickerbocker Dr Ste 3 Sunnyvale CA 94087-1059 Ph: (408) 774-9887 |
| NPI Number | 1194095836 |
|---|---|
| Provider Enumeration Date | 01/11/2012 |
| Last Update Date | 01/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194095836 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DC22529 (California) | Primary |
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