Healthcare Provider Details

I. General information

NPI: 1154710242
Provider Name (Legal Business Name): DAVID MOLANO SR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2015
Last Update Date: 01/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 HARBOR BLVD
BELMONT CA
94002-4018
US

IV. Provider business mailing address

879 LEWIS AVE
SUNNYVALE CA
94086-5906
US

V. Phone/Fax

Practice location:
  • Phone: 650-817-9070
  • Fax: 650-246-3838
Mailing address:
  • Phone: 650-817-9070
  • Fax: 650-246-3838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: