Healthcare Provider Details
I. General information
NPI: 1912650672
Provider Name (Legal Business Name): COUNTY OF SANTA CLARA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/01/2022
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2500 CALIFORNIA ST
MOUNTAIN VIEW CA
94040-1397
US
IV. Provider business mailing address
PO BOX 103331
PASADENA CA
91189-3331
US
V. Phone/Fax
- Phone: 408-885-5000
- Fax:
- Phone: 669-299-8129
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261Q00000X |
| Taxonomy | Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PAUL
E
LORENZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 408-885-4010