Basic Information
| Provider Information | |||||||||
| NPI: | 1336791912 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KPC GLOBAL MEDICAL CENTER OF SAN MATEO COUNTY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 KPC PKWY STE 301 | ||||||||
| Address2: | |||||||||
| City: | CORONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 928797102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9519878100 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1900 SULLIVAN AVE | ||||||||
| Address2: | |||||||||
| City: | DALY CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940152200 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6509924000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/12/2019 | ||||||||
| LastUpdateDate: | 07/12/2019 | ||||||||
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| AuthorizedOfficialLastName: | THOMAS | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
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| AuthorizedOfficialTitleorPosition: | SECRETARY | ||||||||
| AuthorizedOfficialTelephone: | 9519878100 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 273R00000X | Y | Hospital Units | Psychiatric Unit |
No ID Information.