MEDICARE: GUADALUPE HOPE SOCIETY

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	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1801208848
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GUADALUPE HOPE SOCIETY

Provider Business Mailing Address
First Line	:	1900 THE ALAMEDA
Second Line	:	SUITE 630
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1404
Country	:	US
Telephone Number	:	408-609-3373
Fax Number	:	408-609-3383

Provider Business Practice Location Address
First Line	:	1900 THE ALAMEDA
Second Line	:	SUITE 630
City	:	SAN JOSE
State	:	CA
Zip	:	95126-1404
Country	:	US
Telephone Number	:	408-609-3373
Fax Number	:	408-609-3383

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MARY MARGARET O'NEILL
Credential	:	M.D
Telephone Number	:	408-583-0522

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	05/27/2014

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