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General NPI Number Information
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NPI Number | 1548719982
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Entity Type | Organization
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Legal Business Name | SPLENDOR HEALTH CENTER
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Dates
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Enumeration Date | 09/27/2016
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Last Update Date | 09/27/2016
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Provider Practice Location Address
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Address Line | 4155 MOORPARK AVE STE 11
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City | SAN JOSE
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State | CA
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Zip | 95117-1714
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Country | US
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Telephone | 408-821-8827
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Fax |
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Provider Business Mailing Address
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Address Line | 4155 MOORPARK AVE STE 11
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City | SAN JOSE
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State | CA
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Zip | 95117-1714
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Country | US
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Telephone | 408-821-8827
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Fax |
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Authorized Official
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Title or Position | VP
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Name | MR. LAWRENCE MO
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Credential | L. AC.
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Telephone | 408-821-8827
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | AC15174
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License Number State | CA
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