Basic Information
| Provider Information | |||||||||
| NPI: | 1114400280 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ALMA AT ADDISON SURGERY CENTER, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 805 EL CAMINO REAL STE A | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943012315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503273232 | ||||||||
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| Practice Location | |||||||||
| Address1: | 105 ADDISON AVE | ||||||||
| Address2: | |||||||||
| City: | PALO ALTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 943012401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503273232 | ||||||||
| FaxNumber: | 6503271973 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2018 | ||||||||
| LastUpdateDate: | 09/13/2018 | ||||||||
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| AuthorizedOfficialLastName: | PARIKH | ||||||||
| AuthorizedOfficialFirstName: | SACHIN | ||||||||
| AuthorizedOfficialMiddleName: | SHRIKANT | ||||||||
| AuthorizedOfficialTitleorPosition: | CO-CHAIRMAN | ||||||||
| AuthorizedOfficialTelephone: | 6503273232 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QA1903X | Y | Ambulatory Health Care Facilities | Clinic/Center | Ambulatory Surgical |
No ID Information.