Healthcare Provider Details
I. General information
NPI: 1336411511
Provider Name (Legal Business Name): SATELLITE HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/02/2012
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
400 RACE ST SUITE 101
SAN JOSE CA
95126-3518
US
IV. Provider business mailing address
300 SANTANA ROW SUITE 300
SAN JOSE CA
95128-2423
US
V. Phone/Fax
- Phone: 650-404-3600
- Fax: 650-404-6269
- Phone: 650-404-3600
- Fax: 650-625-6269
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QE0700X |
| Taxonomy | End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BERNADETT
VINCENT
Title or Position: PRESIDENT/COO
Credential:
Phone: 650-404-3600