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General NPI Number Information
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NPI Number | 1144389941
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Entity Type | Organization
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Legal Business Name | STANFORD HEALTH CARE TRI-VALLEY
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Dates
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Enumeration Date | 12/07/2006
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 5555 W LAS POSITAS BLVD
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City | PLEASANTON
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State | CA
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Zip | 94588-4000
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Country | US
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Telephone | 925-847-3000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 748618
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City | LOS ANGELES
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State | CA
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Zip | 90074-8618
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Country | US
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Telephone | 925-847-3000
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | MR. KYLE WICHELMANN
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Credential |
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Telephone | 925-847-3000
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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 | 140000114
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License Number State | CA
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