| Dignity Health Medical Foundation | |
|
1301 Shoreway Rd Suite 100 Belmont CA 94002-4151 | |
| (650) 596-7000 | |
| Not Available |
| Full Name | Dignity Health Medical Foundation |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1301 Shoreway Rd, Belmont, California |
| Authorized Official Name and Position | Theresa M Hylen (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 9168512559 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dignity Health Medical Foundation Po Box 742852 Los Angeles CA 90074-2852 Ph: (916) 379-2840 | Dignity Health Medical Foundation 1301 Shoreway Rd Suite 100 Belmont CA 94002-4151 Ph: (650) 596-7000 |
| NPI Number | 1174531859 |
|---|---|
| Provider Enumeration Date | 08/04/2006 |
| Last Update Date | 11/18/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174531859 | NPI | - | NPPES |
| 113737342 | Other | IRS - SP TAX ID | |
| 4601 | Other | HEALTHNET | |
| ZZZ66458Z | Other | CA | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
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Chw Medical Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1301 Shoreway Rd, Suite 100, Belmont, CA 94002 Phone: 650-596-7027 Fax: 650-858-7113 |