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General NPI Number Information
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NPI Number | 1316218605
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Entity Type | Organization
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Legal Business Name | LUCILE PACKARD CHILDREN'S HOSPITAL
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Dates
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Enumeration Date | 01/19/2012
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Last Update Date | 01/19/2012
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Provider Practice Location Address
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Address Line | 321 MIDDLEFIELD RD SUITE 130
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City | MENLO PARK
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State | CA
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Zip | 94025-3500
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Country | US
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Telephone | 650-497-0245
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Fax | 650-462-0225
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Provider Business Mailing Address
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Address Line | 321 MIDDLEFIELD RD SUITE 130
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City | MENLO PARK
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State | CA
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Zip | 94025-3500
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Country | US
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Telephone | 650-497-0245
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Fax | 650-462-0225
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Authorized Official
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Title or Position | DIRECTOR OF REHABILITATION
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Name | MRS. JODY WINZELBERG
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Credential |
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Telephone | 650-498-2738
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282NC2000X
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Taxonomy Name | Children's Hospital
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License Number | 5646
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License Number State | CA
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