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General NPI Number Information
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NPI Number | 1164965620
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HEALTHCARE ALLIANCE
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Dates
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Enumeration Date | 11/30/2016
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Last Update Date | 06/30/2017
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Provider Practice Location Address
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Address Line | 15400 NATIONAL AVE SUITE 201
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City | LOS GATOS
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State | CA
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Zip | 95032-2433
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Country | US
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Telephone | 408-358-8444
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Fax |
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Provider Business Mailing Address
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Address Line | 15400 NATIONAL AVE SUITE 201
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City | LOS GATOS
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State | CA
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Zip | 95032-2433
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Country | US
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Telephone | 408-358-8444
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | KRISTINE RUSLEN
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Credential |
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Telephone | 510-974-8297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State | CA
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