Organization
SANTA CLARA COUNTY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK STANFORD PHD (MANAGER)
(408) 885-5400
Entity
Organization
Contact information
Practice address
2425 ENBORG LN, SAN JOSE, CA 95128-2648
(408) 885-5400
Mailing address
2425 ENBORG LN, SAN JOSE, CA 95128-2648
Taxonomy
Speciality
Code
Description
License number
State
261QM2800X
Methadone Clinic
Primary
—
—
Other
Enumeration date
03/05/2008
Last updated
03/05/2008
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