Healthcare Provider Details

I. General information

NPI: 1508495532
Provider Name (Legal Business Name): MEDEXPERT INTERNATIONAL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2020
Last Update Date: 04/02/2020
Certification Date: 04/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HANCOCK ST
REDWOOD CITY CA
94063-2809
US

IV. Provider business mailing address

PO BOX 7550
MENLO PARK CA
94026-7550
US

V. Phone/Fax

Practice location:
  • Phone: 650-326-6000
  • Fax:
Mailing address:
  • Phone: 650-326-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARY R HILLER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 650-326-6000