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NPI Code Detail

MEDICARE: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY, INC

MEDICARE: INDIAN HEALTH CENTER OF SANTA CLARA VALLEY, INC
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
1261QD0000XDental Clinic/Center36971CA

General Provider Information

NPI Number : 1386663300
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDIAN HEALTH CENTER OF SANTA CLARA VALLEY, INC
Provider Business Mailing Address
First Line : 1333 MERIDIAN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-5212
Country : US
Telephone Number : 408-445-3410
Fax Number : 408-269-9273
Provider Business Practice Location Address
First Line : 1333 MERIDIAN AVE
Second Line :
City : SAN JOSE
State : CA
Zip : 95125-5212
Country : US
Telephone Number : 408-445-3410
Fax Number : 408-269-9273
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MS. LIZ HUNT
Credential :
Telephone Number : 408-445-3410
Provider Enumeration Date : 07/19/2006
Last Update Date : 08/22/2020

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Directions to “INDIAN HEALTH CENTER OF SANTA CLARA VALLEY, INC ” Practice Location

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