Healthcare Provider Details

I. General information

NPI: 1710041694
Provider Name (Legal Business Name): GOOD SAMARITAN HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 SAMARITAN DR
SAN JOSE CA
95124-3908
US

IV. Provider business mailing address

2425 SAMARITAN DR
SAN JOSE CA
95124-3908
US

V. Phone/Fax

Practice location:
  • Phone: 408-559-2011
  • Fax: 408-559-2533
Mailing address:
  • Phone: 408-559-2011
  • Fax: 408-559-2533

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateCA

VIII. Authorized Official

Name: DR. PAUL BEAUPRE
Title or Position: CMO.
Credential: MD
Phone: 408-559-2358