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General NPI Number Information
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NPI Number | 1457078651
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Entity Type | Organization
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Legal Business Name | SILICON VALLEY DIGESTIVE HEALTH INC.
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Dates
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Enumeration Date | 10/27/2022
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Last Update Date | 12/20/2022
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Provider Practice Location Address
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Address Line | 805 EL CAMINO REAL STE A
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City | PALO ALTO
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State | CA
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Zip | 94301-2315
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Country | US
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Telephone | 650-324-8878
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Fax | 650-487-8595
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Provider Business Mailing Address
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Address Line | 805 EL CAMINO REAL STE A
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City | PALO ALTO
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State | CA
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Zip | 94301-2315
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Country | US
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Telephone | 650-324-8878
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Fax | 650-487-8595
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. SUSIE LIU
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Credential | M.D.
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Telephone | 650-324-8878
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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