Provider Demographics
NPI:1538348750
Name:MAYVIEW COMMUNITY CLINIC
Entity type:Organization
Organization Name:MAYVIEW COMMUNITY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-327-9734
Mailing Address - Street 1:100 MOFFETT BLVD
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-4721
Mailing Address - Country:US
Mailing Address - Phone:650-965-3323
Mailing Address - Fax:650-965-0706
Practice Address - Street 1:100 MOFFETT BLVD
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94043-4721
Practice Address - Country:US
Practice Address - Phone:650-965-3323
Practice Address - Fax:650-965-0706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-25
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA18541261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center