Healthcare Provider Details

I. General information

NPI: 1295650927
Provider Name (Legal Business Name): PECH5 MG OC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROBLE AVE
MENLO PARK CA
94025-4908
US

IV. Provider business mailing address

800 ROBLE AVE
MENLO PARK CA
94025-4908
US

V. Phone/Fax

Practice location:
  • Phone: 408-807-1984
  • Fax: 650-980-8777
Mailing address:
  • Phone: 408-807-1984
  • Fax: 650-980-8777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code177F00000X
TaxonomyLodging Provider
License Number
License Number State

VIII. Authorized Official

Name: NEERU VERMA
Title or Position: ADMINISTRATOR
Credential:
Phone: 408-807-1984