Organization
SOUTH COUNTY COMMUNITY HEALTH CENTER INC
Active
Other names
Ravenswood Family Health Network
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GRALYN JACQUES (CFO)
(650) 330-7400
Entity
Organization
Contact information
Practice address
1885 BAY ROAD, EAST PALO ALTO, CA 94303-1611
(650) 330-7400
(650) 321-1560
Mailing address
1885 BAY ROAD, EAST PALO ALTO, CA 94303-1611
(650) 330-7400
(650) 321-1560
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
261QP2300X
Primary Care Clinic/Center
Primary
—
CA
261QP2300X
Primary Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP70935F
CANCER DETECTION PROGRAM
CA
01
—
EAP70935F
EAPC
CA
05
—
FHC70935F
—
CA
01
—
HAP70935F
FAMILY PACT
CA
Enumeration date
10/19/2006
Last updated
02/01/2022
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