Healthcare Provider Details
I. General information
NPI: 1578382545
Provider Name (Legal Business Name): XALA HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2024
Last Update Date: 10/07/2024
Certification Date: 10/07/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4701 PATRICK HENRY DR BLDG 25 STE 134
SANTA CLARA CA
95054-1819
US
IV. Provider business mailing address
4701 PATRICK HENRY DR BLDG 25 STE 134
SANTA CLARA CA
95054-1819
US
V. Phone/Fax
- Phone: 408-320-5510
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SHEIDA
IRANMANESH
Title or Position: DIRECTOR OF OPERATIONS
Credential: MPH
Phone: 408-320-5510