EAST VALLEY COMMUNITY CLINIC INC. NPI 1700830296

NPI Information

EAST VALLEY COMMUNITY CLINIC, INC. is a community health clinic center in San Jose, CA. EAST VALLEY COMMUNITY CLINIC, INC. NPI is 1700830296. The provider is registered as an organization entity type.
The provider Is Doing Business As Mar Monte Community Clinic.

The provider's business location address is:

2470 ALVIN AVE
SUITE 60
SAN JOSE, CA
ZIP 95121-664
Phone: (408) 274-7100
Fax: (408) 274-8763

The provider's authorized official is Rayroz Dodson-crawford .
The authorized official title is Cfo and has the following contact phone number (408) 795-3607.

The enumeration date for this NPI number is 5/20/2006 and was last updated on 3/25/2014.

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:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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