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NPI Code Detail

MEDICARE: ELIZA KATE PLANK RICHARD

MEDICARE:   ELIZA KATE PLANK RICHARD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorCA

General Provider Information

NPI Number : 1124636519
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZA KATE PLANK RICHARD
Provider Business Mailing Address
First Line : 25 N 14TH ST STE 400
Second Line :
City : SAN JOSE
State : CA
Zip : 95112-6217
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 701 CURTNER AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-2037
Country : US
Telephone Number : 408-775-8775
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2020
Last Update Date : 07/21/2020

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Directions to “ ELIZA KATE PLANK RICHARD ” Practice Location

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