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General NPI Number Information
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NPI Number | 1124281100
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Entity Type | Organization
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Legal Business Name | KAISER PERMANETE SANTA CLARA
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Dates
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Enumeration Date | 07/09/2008
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Last Update Date | 07/09/2008
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Provider Practice Location Address
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Address Line | 710 LAWRENCE EXPY GME DEPT. 384
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City | SANTA CLARA
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State | CA
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Zip | 95051-5173
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Country | US
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Telephone | 408-851-3841
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Fax |
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Provider Business Mailing Address
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Address Line | 710 LAWRENCE EXPWY GME DEPT 384
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City | SANTA CLARA
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State | CA
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Zip | 95051
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Country | US
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Telephone | 408-851-3841
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Fax |
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Authorized Official
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Title or Position | RESISENT
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Name | JOHN WILLIAM PHILLIP
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Credential | M.D.
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Telephone | 408-851-7225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | XXXXXXXXXXXXXXXXXXX
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License Number State | CA
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