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General NPI Number Information
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NPI Number | 1659914653
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Entity Type | Organization
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Legal Business Name | KANGAROOHEALTH, INC.
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 2627 HANOVER ST
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City | PALO ALTO
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State | CA
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Zip | 94304-1118
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Country | US
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Telephone | 408-641-5446
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Fax |
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Provider Business Mailing Address
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Address Line | 370 ELAN VILLAGE LN UNIT 220
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City | SAN JOSE
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State | CA
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Zip | 95134-2534
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Country | US
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Telephone | 408-641-5446
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. XIAOXU KANG
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Credential | PHD
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Telephone | 408-641-5446
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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