| Santa Clara Medical Group Inc | |
|
1150 Scott Blvd Suite B-1 Santa Clara CA 95050-4547 | |
| (408) 241-2900 | |
| (408) 244-1696 |
| Full Name | Santa Clara Medical Group Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 1150 Scott Blvd, Santa Clara, California |
| Authorized Official Name and Position | Dhanu Kapoor (PRESIDENT) |
| Authorized Official Contact | 4082412900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Clara Medical Group Inc 1150 Scott Blvd Suite B-1 Santa Clara CA 95050-4547 Ph: (408) 241-2900 | Santa Clara Medical Group Inc 1150 Scott Blvd Suite B-1 Santa Clara CA 95050-4547 Ph: (408) 241-2900 |
| NPI Number | 1306918461 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 01/07/2013 |
| Medicare PECOS PAC ID | 7113020801 |
|---|---|
| Medicare Enrollment ID | O20070319000229 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306918461 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | A80435 (California) | Primary |
| Provider Name | Dhanu Kapoor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942212758 PECOS PAC ID: 3476656166 Enrollment ID: I20070319000249 |
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