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General NPI Number Information
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NPI Number | 1679342281
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Entity Type | Organization
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Legal Business Name | SUTTER BAY MEDICAL FOUNDATION
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Dates
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Enumeration Date | 12/22/2023
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Last Update Date | 03/04/2024
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Provider Practice Location Address
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Address Line | 393 BLOSSOM HILL RD STE 365
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City | SAN JOSE
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State | CA
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Zip | 95123-1659
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Country | US
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Telephone | 408-203-3941
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Fax |
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Provider Business Mailing Address
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Address Line | 701 E EL CAMINO REAL
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2833
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ELIZABETH VILARDO
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Credential |
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Telephone | 510-450-7354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS0132X
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Taxonomy Name | Ophthalmologic Surgery Clinic/Center
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License Number |
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License Number State |
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