MEDICARE: O'CONNOR HOSPITAL HOME HEALTH CARE AGENCY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency		CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053392308
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	O'CONNOR HOSPITAL HOME HEALTH CARE AGENCY

Provider Business Mailing Address
First Line	:	2105 FOREST AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-1425
Country	:	US
Telephone Number	:	408-947-2724
Fax Number	:	408-947-3431

Provider Business Practice Location Address
First Line	:	2030 FOREST AVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-4833
Country	:	US
Telephone Number	:	408-947-2724
Fax Number	:	408-947-3431

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS
Name	:	MS. CHERYL BARTON
Credential	:	R.N.
Telephone Number	:	408-947-2724

Provider Enumeration Date	:	11/11/2005
Last Update Date	:	08/22/2020

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Directions to “O'CONNOR HOSPITAL HOME HEALTH CARE AGENCY ” Practice Location

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