Organization
INDIAN HEALTH CENTER OF SANTA CLARA VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA E EDMO (HUMAN RESOURCE DIRECTOR)
(408) 445-3400
Entity
Organization
Contact information
Practice address
1333 MERIDIAN AVE, SAN JOSE, CA 95125-5212
(408) 445-3400
(408) 448-1041
Mailing address
1333 MERIDIAN AVE, SAN JOSE, CA 95125-5212
(408) 445-3400
(408) 448-1041
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
070000118
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAP11833F
FAMILY PACT PROGRAM
CA
Enumeration date
05/28/2008
Last updated
06/30/2011
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