Provider Demographics
NPI:1356001259
Name:COUNTY OF SAN MATEO
Entity Type:Organization
Organization Name:COUNTY OF SAN MATEO
Other - Org Name:IMAT ECM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUENDL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-573-2491
Mailing Address - Street 1:2000 ALAMEDA DE LAS PULGAS STE 280
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94403-1289
Mailing Address - Country:US
Mailing Address - Phone:650-573-2509
Mailing Address - Fax:650-573-2110
Practice Address - Street 1:2000 ALAMEDA DE LAS PULGAS STE 280
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-1289
Practice Address - Country:US
Practice Address - Phone:650-573-2509
Practice Address - Fax:650-573-2110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-20
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health