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General NPI Number Information
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NPI Number | 1376354233
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Entity Type | Organization
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Legal Business Name | BLANCA SANA
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Dates
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Enumeration Date | 01/18/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1339 SEVIER AVE
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City | MENLO PARK
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State | CA
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Zip | 94025-1511
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Country | US
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Telephone | 650-263-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 1339 SEVIER AVE
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City | MENLO PARK
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State | CA
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Zip | 94025-1511
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Country | US
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Telephone | 650-263-1950
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TSEGEREDA MULUGETA
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Credential |
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Telephone | 650-263-1950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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