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BLUE LOTUS CONNECTION NPI 1760997902


NPI Information

NPI: 1760997902
Provider Name: BLUE LOTUS CONNECTION
Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
1700 S AMPHLETT BLVD, STE 250B
SAN MATEO, CA
ZIP 94402
Phone: (650) 619-9942
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BLUE LOTUS CONNECTION is a point of service in San Mateo, CA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. BLUE LOTUS CONNECTION NPI is 1760997902. The provider is registered as an organization entity type.

The provider's business location address is:

1700 S AMPHLETT BLVD, STE 250B
SAN MATEO, CA
ZIP 94402
Phone: (650) 619-9942

The provider's authorized official is Patrice Fortune .
The authorized official title is Founder/owner and has the following contact phone number (650) 619-9942.

The enumeration date for this NPI number is 12/11/2017 and was last updated on 12/11/2017.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305S00000XPoint of ServiceCALIFORNIAYes

Other Identifiers

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

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11235368135MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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