Indian Health Center Of Santa Clara Valley

LBN: Indian Health Center Of Santa Clara Valley
Indian Health Center Of Santa Clara Valley is an health care organization with primary practice located at 1333 Meridian Ave , San Jose CA 95125-5212. The organization recently has 2 registered licenses in different health care specialties including Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center). Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty. Indian Health Center Of Santa Clara Valley can be contacted via phone (408) 445-3400, or through Scott, Aldon Wayne via phone (408) 445-3400.

Contact Information

Primary practice address
1333 Meridian Ave San Jose CA 95125-5212
Phone: (408) 445-3400
Fax: (408) 448-1727
Website:
Map and Directions
Authorized official contact:
Name: Scott, Aldon Wayne Doctor of Medicine (DM)
Phone: (408) 445-3400

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 070000118 California
Ambulatory Health Care Facilities / Mental Health (Including Community Mental Health Center) 261QM0801X 070000118 California

Profile Details

NPI number 1164643862
LBN Legal business name Indian Health Center Of Santa Clara Valley
DBA Doing business as
Authorized official Scott, Aldon Wayne Doctor of Medicine (DM)
Entity Organization
Organization subpart 1 No
Enumeration date May 1st, 2007
Last updated Jun 10th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164643862 NPPES
California MEDICAID FHC11833F
California Other G01133-01
California Other FHC11833F

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