# SAMARITAN HOUSE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891247847
- **Authorized official:** DR. JASON WONG MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (650) 257-5286

## Contact information

- **Practice address:** 19 W 39TH AVE, SAN MATEO, CA 94403-4593
- **Practice address phone:** (650) 578-0400
- **Practice address fax:** (650) 578-0440
- **Mailing address:** 4031 PACIFIC BLVD, SAN MATEO, CA 94403-4666
- **Mailing address phone:** (650) 341-4081
- **Mailing address fax:** (650) 341-0526

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 220000275 | CA | Yes |

## Other

- **Enumeration date:** 10/25/2016
- **Last updated:** 10/25/2016