Organization
GARDNER FAMILY HEALTH NETWORK INC
Active
Parent organization
GARDNER FAMILY HEALTH NETWORK INC
Other names
GARDNER SOUTH COUNTY
Organization subpart
Yes
Provider details
NPI number
Legal business name
GARDNER FAMILY HEALTH NETWORK INC
Authorized official
OFELIA RUIZ (DIRECTOR)
(408) 935-3971
Entity
Organization
Contact information
Practice address
7526 MONTEREY ST, GILROY, CA 95020-5826
(408) 935-3933
(408) 935-3988
Mailing address
PO BOX 1240, ALVISO, CA 95002-1240
(408) 935-3933
(408) 935-3982
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251X00000X
Supports Brokerage Agency
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
FHC707872F
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP707872F
BCEDPGIL
CA
01
—
EAP707872F
EAPCGIL
CA
05
—
FHC70872F
—
CA
01
—
HAP70872F
SOFPGIL
CA
Enumeration date
03/02/2007
Last updated
05/04/2023
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