Provider Demographics
NPI:1861895591
Name:SAMARITAN ADVANCED HEALTHCARE INC
Entity type:Organization
Organization Name:SAMARITAN ADVANCED HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:MEILAN
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-560-9470
Mailing Address - Street 1:2505 SAMARITAN DR STE 305
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124-4011
Mailing Address - Country:US
Mailing Address - Phone:408-560-9740
Mailing Address - Fax:408-560-9278
Practice Address - Street 1:2505 SAMARITAN DR STE 305
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-4011
Practice Address - Country:US
Practice Address - Phone:408-560-9470
Practice Address - Fax:408-560-9278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-08
Last Update Date:2014-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 16083171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty