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221 E Hacienda Ave Ste B Campbell CA 95008-6625 | |
| (408) 376-3350 | |
| (408) 374-4130 |
| Full Name | |
|---|---|
| Speciality | Family Medicine - Sports Medicine |
| Location | 221 E Hacienda Ave Ste B, Campbell, California |
| Authorized Official Name and Position | Sean Morrissey (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 4083763350 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
221 E Hacienda Ave Ste B Campbell CA 95008-6625 Ph: (408) 376-3350 | 221 E Hacienda Ave Ste B Campbell CA 95008-6625 Ph: (408) 376-3350 |
| NPI Number | 1871074500 |
|---|---|
| Provider Enumeration Date | 08/21/2018 |
| Last Update Date | 08/21/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871074500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QS0010X | Family Medicine - Sports Medicine | (California) | Primary |
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