Organization
SANTA CRUZ MEDICAL FOUNDATION PALO ALTO MEDICAL FOUNDATION
Active
Parent organization
MEDVANTX, INC.
Other names
Sutter Santa Cruz Aptos
Organization subpart
Yes
Provider details
NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OPERATIONS)
(858) 625-2990
Entity
Organization
Contact information
Practice address
7600 OLD DOMINION CT, 1ST, APTOS, CA 95003-3821
(831) 458-6200
Mailing address
5626 OBERLIN DR, SUITE 110, SAN DIEGO, CA 92121-1705
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
A63459
CA
Other
Enumeration date
07/02/2008
Last updated
10/22/2012
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