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General NPI Number Information
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NPI Number | 1184922510
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Entity Type | Organization
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Legal Business Name | PERPETUAL HELP MEDICAL CENTER
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Dates
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Enumeration Date | 03/09/2011
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Last Update Date | 03/09/2011
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Provider Practice Location Address
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Address Line | 901 SUNSET DR SUITE 4
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City | HOLLISTER
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State | CA
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Zip | 95023-5613
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Country | US
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Telephone | 831-636-1571
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Fax | 831-636-1706
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Provider Business Mailing Address
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Address Line | 901 SUNSET DR SUITE 4
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City | HOLLISTER
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State | CA
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Zip | 95023-5613
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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 | OFFICE MANAGER
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Name | MR. DENNIS SANTA MARIA
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Credential |
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Telephone | 831-636-1571
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A98158
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License Number State | CA
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