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Organization

PALO ALTO MEDICAL FOUNDATION

Active
Parent organization
MEDVANTX, INC.
Other names
Sutter Sant Cruz Main 4th Floor
Organization subpart
Yes

Provider details

NPI number
Legal business name
MEDVANTX, INC.
Authorized official
KENNY HEINE (DIRECTOR OF OPERATIONS)
(858) 625-2990
Entity
Organization

Contact information

Practice address
2025 SOQUEL AVE, 4TH FLOOR, SANTA CRUZ, CA 95062-1323
(831) 458-5610
Mailing address
5810 NANCY RIDGE DR, 100, SAN DIEGO, CA 92121-2834
(858) 625-2990

Taxonomy

Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
G84273
CA

Other

Enumeration date
07/24/2008
Last updated
07/25/2008
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