Healthcare Provider Details

I. General information

NPI: 1417009705
Provider Name (Legal Business Name): AFTER HOUR PEDIATRICS URGENT CARE CLINIC, A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 01/26/2021
Certification Date: 01/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 BALDWIN AVE
SAN MATEO CA
94401-3915
US

IV. Provider business mailing address

210 BALDWIN AVE
SAN MATEO CA
94401-3915
US

V. Phone/Fax

Practice location:
  • Phone: 510-579-6581
  • Fax: 650-579-7851
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CONNIE STREIFINGER KNIVETON
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 650-579-6581