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General NPI Number Information
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NPI Number | 1801208848
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Entity Type | Organization
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Legal Business Name | GUADALUPE HOPE SOCIETY
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Dates
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Enumeration Date | 05/27/2014
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Last Update Date | 05/27/2014
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Provider Practice Location Address
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Address Line | 1900 THE ALAMEDA SUITE 630
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City | SAN JOSE
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State | CA
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Zip | 95126-1404
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Country | US
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Telephone | 408-609-3373
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Fax | 408-609-3383
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Provider Business Mailing Address
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Address Line | 1900 THE ALAMEDA SUITE 630
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City | SAN JOSE
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State | CA
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Zip | 95126-1404
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Country | US
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Telephone | 408-609-3373
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Fax | 408-609-3383
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MARY MARGARET O'NEILL
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Credential | M.D
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Telephone | 408-583-0522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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