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General NPI Number Information
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NPI Number | 1740909969
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Entity Type | Organization
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Legal Business Name | SALLY GREENWALD, MD INC
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 08/22/2022
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Provider Practice Location Address
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Address Line | 211 QUARRY RD STE 203
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City | PALO ALTO
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State | CA
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Zip | 94304-1416
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Country | US
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Telephone | 781-718-3024
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Fax |
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Provider Business Mailing Address
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Address Line | 16 PERRY AVE
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City | MENLO PARK
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State | CA
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Zip | 94025-6172
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Country | US
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Telephone | 781-718-3024
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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. SALLY ROSE GREENWALD
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Credential | MD MPH
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Telephone | 781-718-3024
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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