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NPI Code Detail

MEDICARE: SAN MATEO MEDICAL CENTER

MEDICARE: SAN MATEO MEDICAL CENTER
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
1261QD0000XDental Clinic/Center

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G98080-01OTHERCADELTA DENTAL

General Provider Information

NPI Number : 1962577957
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAN MATEO MEDICAL CENTER
Provider Business Mailing Address
First Line : 222 W 39TH AVE
Second Line :
City : SAN MATEO
State : CA
Zip : 94403-4364
Country : US
Telephone Number : 650-573-2222
Fax Number :
Provider Business Practice Location Address
First Line : 2710 MIDDLEFIELD RD
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-3404
Country : US
Telephone Number : 650-573-2222
Fax Number :
Authorized Official
Title or Position : REIMBUREMENT
Name : KRIS ROZZI
Credential :
Telephone Number : 650-573-2120
Provider Enumeration Date : 11/22/2006
Last Update Date : 08/22/2020

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Directions to “SAN MATEO MEDICAL CENTER ” Practice Location

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