MEDICARE: SUMMIT ESTATE RECOVERY CENTERS LLC

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
1	324500000X	Substance Abuse Rehabilitation Facility

General Provider Information

NPI Number	:	1750263810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT ESTATE RECOVERY CENTERS LLC

Provider Business Mailing Address
First Line	:	7280 BLUE HILL DR STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-3624
Country	:	US
Telephone Number	:	800-701-6997
Fax Number	:	323-576-5345

Provider Business Practice Location Address
First Line	:	7280 BLUE HILL DR STE 7
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95129-3624
Country	:	US
Telephone Number	:	800-701-6997
Fax Number	:	323-576-5345

Authorized Official
Title or Position	:	BILLER
Name	:	ELIZABETH HERNANDEZ
Credential	:
Telephone Number	:	818-983-9466

Provider Enumeration Date	:	07/21/2025
Last Update Date	:	07/21/2025

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1932516622 — MR. DAVID JORDAN MFTI
Practice Location Address:

7280 BLUE HILL DR STE 7
SAN JOSE, CA
95129-3624

Practice Phone: 650-713-1362
Practice Fax:

1558195313 — CASSIDY HOZER
Practice Location Address:

7280 BLUE HILL DR STE 7
SAN JOSE, CA
95129-3624

Practice Phone: 866-679-9855
Practice Fax:

1144489568 — FLORENTINO MENOR
Practice Location Address:

1307 MAYBERRY LN
SAN JOSE, CA
95131-3624

Practice Phone: 408-813-5455
Practice Fax: 408-907-8933

1326348483 — MR. WAYNE CHAN PHARM D
Practice Location Address:

5760 COTTLE RD
SAN JOSE, CA
95123-3624

Practice Phone: 408-362-9623
Practice Fax:

1114320306 — SAFEWAY INC
Practice Location Address:

5760 COTTLE RD
SAN JOSE, CA
95123-3624

Practice Phone: 408-362-9623
Practice Fax: 408-362-9741

Directions to “SUMMIT ESTATE RECOVERY CENTERS LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.