Provider Demographics
NPI:1235274044
Name:GARDNER FAMILY HEALTH NETWORK
Entity Type:Organization
Organization Name:GARDNER FAMILY HEALTH NETWORK
Other - Org Name:GARDNER SPECIAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:REYMUNDO
Authorized Official - Middle Name:C
Authorized Official - Last Name:ESPINOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-200-2291
Mailing Address - Street 1:3030 ALUM ROCK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-2807
Mailing Address - Country:US
Mailing Address - Phone:408-254-3396
Mailing Address - Fax:408-254-2383
Practice Address - Street 1:3030 ALUM ROCK AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-2807
Practice Address - Country:US
Practice Address - Phone:408-254-3396
Practice Address - Fax:408-254-2383
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:GARDNER FAMILY HEALTH NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-20
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes305S00000XManaged Care OrganizationsPoint of Service
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty