=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326158411
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | KAISER PERMANENTE SANTA CLARA MEDICAL CENTER
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 20333 MERIDA DRIVE
-----------------------------------------------------
City | SARATOGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95070-3123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-851-9001
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20333 MERIDA DR
-----------------------------------------------------
City | SARATOGA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95070-3123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-851-9001
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | RNP
-----------------------------------------------------
Name | MS. HUI-YING YANG
-----------------------------------------------------
Credential | RNP
-----------------------------------------------------
Telephone | 408-851-9001
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 12217
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------