Basic Information
| Provider Information | |||||||||
| NPI: | 1316593965 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | MICHELLE E PEZZANI, MD, A MEDICAL CORPORATION | ||||||||
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| Mailing Information | |||||||||
| Address1: | 650 CASTRO ST STE 120-462 | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940412055 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6502795143 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2500 GRANT RD | ||||||||
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| City: | MOUNTAIN VIEW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940404378 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6509407000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/09/2019 | ||||||||
| LastUpdateDate: | 08/09/2019 | ||||||||
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| AuthorizedOfficialLastName: | PEZZANI | ||||||||
| AuthorizedOfficialFirstName: | MICHELLE | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 6502795143 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | Y | Hospitals | General Acute Care Hospital |
No ID Information.