Organization
SAN MATEO MEDICAL CENTER METHADONE TREATMENT PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA DEAN (DIRECTOR)
(650) 578-7190
Entity
Organization
Contact information
Practice address
795 WILLOW RD, BUILDING 332, MENLO PARK, CA 94025-2539
(650) 578-7190
Mailing address
222 W 39TH AVE, SAN MATEO, CA 94403-4364
(650) 573-2222
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
4104
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HDC70098F
—
CA
Enumeration date
04/23/2007
Last updated
08/22/2020
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