1275703571 NPI number — A & C HEALTH CARE SERVICES, INC.

Table of content: (NPI 1275703571)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275703571 NPI number — A & C HEALTH CARE SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
A & C HEALTH CARE SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275703571
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/01/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5615 COTTLE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JOSE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95123-3625
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-226-0300
Provider Business Mailing Address Fax Number:
408-226-3800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 MATEO AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MILLBRAE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94030-2037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
650-583-8937
Provider Business Practice Location Address Fax Number:
650-583-2647
Provider Enumeration Date:
03/03/2008

Additional Information

Authorized Official

Authorized Official Last Name:
RAGUDO
Authorized Official First Name:
AMPARO
Authorized Official Middle Name:
B
Authorized Official Title or Position:
C.F.O.
Authorized Official Telephone Number:
408-226-0300

Provider Taxonomy Codes

  • Taxonomy code: 314000000X , with the licence number:  220000050 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05-6122 ZZR06122G . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".
  • Identifier: 05-6122 ZZR06122G , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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