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General NPI Number Information
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NPI Number | 1063834943
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Entity Type | Organization
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Legal Business Name | LUCILE PACKARD CHILDRENS HOSPITAL
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 730 WELCH RD
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City | PALO ALTO
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State | CA
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Zip | 94304-1503
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Country | US
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Telephone | 650-736-7233
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Fax |
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Provider Business Mailing Address
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Address Line | 730 WELCH RD
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City | PALO ALTO
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State | CA
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Zip | 94304-1503
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZATION COORDINATOR
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Name | MELE TOA
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Credential |
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Telephone | 650-736-7233
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number |
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License Number State | CA
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