Healthcare Provider Details

I. General information

NPI: 1942355292
Provider Name (Legal Business Name): PALO ALTO MEDICAL FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 EL CAMINO REAL
PALO ALTO CA
94301-2302
US

IV. Provider business mailing address

795 EL CAMINO REAL
PALO ALTO CA
94301-2302
US

V. Phone/Fax

Practice location:
  • Phone: 650-853-6066
  • Fax: 650-330-0183
Mailing address:
  • Phone: 650-853-6066
  • Fax: 650-330-0183

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number44373
License Number StateCA

VIII. Authorized Official

Name: DR. FRANCIS MARZONI
Title or Position: PRESIDENT
Credential: M.D.
Phone: 650-321-4121