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General NPI Number Information
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NPI Number | 1396098976
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Entity Type | Organization
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Legal Business Name | SIMPLY GREATH HEALTH
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Dates
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Enumeration Date | 10/20/2012
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Last Update Date | 10/20/2012
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Provider Practice Location Address
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Address Line | 360 DARDANELLI LN STE 1C
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City | LOS GATOS
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State | CA
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Zip | 95032-1421
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Country | US
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Telephone | 408-656-0815
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Fax |
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Provider Business Mailing Address
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Address Line | 360 DARDANELLI LN STE 1C
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City | LOS GATOS
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State | CA
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Zip | 95032-1421
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Country | US
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Telephone | 408-656-0815
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. SUMA SINGH
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Credential | MD
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Telephone | 408-656-0815
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0405X
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Taxonomy Name | Substance Use Disorder Rehabilitation Clinic/Center
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License Number | G79389
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number | G79389
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License Number State | CA
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