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General NPI Number Information
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NPI Number | 1184677163
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Entity Type | Organization
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Legal Business Name | PLANNED PARENTHOOD MAR MONTE, INC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 5700 WATT AVE
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City | NORTH HIGHLANDS
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State | CA
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Zip | 95660-4752
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Country | US
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Telephone | 916-332-5715
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Fax | 916-332-1849
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Provider Business Mailing Address
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Address Line | 1691 THE ALAMEDA
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City | SAN JOSE
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State | CA
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Zip | 95126-2203
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Country | US
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Telephone | 409-795-3600
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Fax | 408-971-6935
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Authorized Official
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Title or Position | CFO
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Name | MR. TOM MOTSIFF
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Credential | MHA, CMA
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Telephone | 408-795-3707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 030000346
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License Number State | CA
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