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NPI Code Detail

MEDICARE: PATHWAY SOCIETY, INC

MEDICARE: PATHWAY SOCIETY, INC
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
1302R00000XHealth Maintenance Organization

General Provider Information

NPI Number : 1144657289
Entity Type Code : Organization
Provider Name (Legal Business Name) : PATHWAY SOCIETY, INC
Provider Business Mailing Address
First Line : PO BOX 13219
Second Line :
City : COYOTE
State : CA
Zip : 95013-3219
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1659 SCOTT BLVD STE 30
Second Line :
City : SANTA CLARA
State : CA
Zip : 95050-4137
Country : US
Telephone Number : 408-281-6594
Fax Number :
Authorized Official
Title or Position : EXECUTIVE
Name : MR. GARY MONTREZZA
Credential :
Telephone Number : 408-244-5123
Provider Enumeration Date : 10/03/2013
Last Update Date : 10/03/2013

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Directions to “PATHWAY SOCIETY, INC ” Practice Location

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