Cccma

NPI 1174955587 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1174955587
Enumeration Date 08/07/2013
Last Updated 08/07/2013
Entity Type Healthcare Provider
Active Over 3 years ago
Authorized Information
Name ASH ASH
Position CEO
Phone (650) 302-5864
Fax
Practice Location
1149 FERNWOOD DR
MILLBRAE CA, 94030-1011, US
Phone (650) 302-5864
Fax
Business Location
27206 CALAROGA AVE
HAYWARD CA, 94545-4300, US
Phone
Fax
Toxanomy
Taxonomy Code 363LF0000X
License State California
License Number 22677
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According to our database, Cccma NPI is 1174955587, taxonomy code is 363LF0000X and license number is 22677, license state is located at California. Cccma physically located at 1149 Fernwood Dr, Millbrae CA, 94030-1011. NPI Number 1033115704 has the healthcare provider type.

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1174955587 NPI number is provided on an as is basis without warranty of any kind. 1174955587 is maintained by the National Plan & Provider Enumeration System. The contents of Cccma are for informational purposes only.