Provider Demographics
NPI:1033581921
Name:SANTA TERESA MEDICAL CENTER INC
Entity Type:Organization
Organization Name:SANTA TERESA MEDICAL CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:F
Authorized Official - Last Name:HUERTA-IBARRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-779-7348
Mailing Address - Street 1:50 E MAIN AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-3661
Mailing Address - Country:US
Mailing Address - Phone:408-779-7348
Mailing Address - Fax:408-779-7349
Practice Address - Street 1:50 E MAIN AVE
Practice Address - Street 2:STE. A
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-3661
Practice Address - Country:US
Practice Address - Phone:408-779-7348
Practice Address - Fax:408-779-7349
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-30
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACA200173OtherPTAN