Provider Demographics
NPI:1417173204
Name:PAVAHCS
Entity Type:Organization
Organization Name:PAVAHCS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINSTRATIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:
Authorized Official - Last Name:AMASOL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-493-5000
Mailing Address - Street 1:253 YALE RD
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-5227
Mailing Address - Country:US
Mailing Address - Phone:650-322-0211
Mailing Address - Fax:650-496-2573
Practice Address - Street 1:3801 MIRANDA AVE
Practice Address - Street 2:(123)
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1207
Practice Address - Country:US
Practice Address - Phone:650-493-5000
Practice Address - Fax:650-496-2573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN271154282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital