PALO ALTO MEDICAL FOUNDATION NPI 1114182649

NPI Information

PALO ALTO MEDICAL FOUNDATION is a non pharmacy dispensing site in Santa Cruz, CA. The provider is a site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) PALO ALTO MEDICAL FOUNDATION NPI is 1114182649. The provider is registered as an organization entity type.
The provider Is Doing Business As Sutter Sant Cruz Main 4th Floor.

The provider's business location address is:

2025 SOQUEL AVE
4TH FLOOR
SANTA CRUZ, CA
ZIP 95062-323
Phone: (831) 458-5610

The provider's authorized official is Kenny Heine .
The authorized official title is Director Of Operations and has the following contact phone number (858) 625-2990.

The CLIA number assigned to this NPI record is 05D0606752 - ancillary testing site in health care center with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 7/24/2008 and was last updated on 7/25/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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