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General NPI Number Information
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NPI Number | 1619046075
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Entity Type | Organization
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Legal Business Name | SAN BENITO COUNTY MEDICAL THERAPY UNIT
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Dates
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Enumeration Date | 11/07/2006
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 761 SOUTH ST
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City | HOLLISTER
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State | CA
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Zip | 95023-4570
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Country | US
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Telephone | 831-637-1989
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Fax | 831-638-9753
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Provider Business Mailing Address
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Address Line | 439 4TH ST
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City | HOLLISTER
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State | CA
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Zip | 95023-3801
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Country | US
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Telephone | 831-637-5367
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Fax | 831-637-9073
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Authorized Official
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Title or Position | HEALTH OFFICER
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Name | DR. ELIZABETH A FALADE
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Credential | M.D.
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Telephone | 831-637-5367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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