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General NPI Number Information
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NPI Number | 1316221617
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Entity Type | Organization
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Legal Business Name | PLANNED PARENTHOOD MAR MONTE
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Dates
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Enumeration Date | 10/05/2011
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Last Update Date | 07/25/2019
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Provider Practice Location Address
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Address Line | 29 BAYWOOD AVE
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City | SAN MATEO
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State | CA
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Zip | 94402-1516
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Country | US
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Telephone | 650-375-1831
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Fax |
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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 | 408-795-3619
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Fax | 408-287-0405
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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 |
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License Number State | CA
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