Healthcare Provider Details

I. General information

NPI: 1336733138
Provider Name (Legal Business Name): COUNTY OF SANTA CLARA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2021
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 S 2ND ST
SAN JOSE CA
95112-5974
US

IV. Provider business mailing address

PO BOX 398407
SAN FRANCISCO CA
94139-8407
US

V. Phone/Fax

Practice location:
  • Phone: 408-885-5000
  • Fax:
Mailing address:
  • Phone: 669-299-8083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: PAUL E LORENZ
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 408-885-4010