Provider Demographics
NPI:1497740401
Name:SETON MEDICAL CENTER
Entity Type:Organization
Organization Name:SETON MEDICAL CENTER
Other - Org Name:WEST BAY HOME HEALTH & COMMUNITY SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:650-991-6396
Mailing Address - Street 1:45 SOUTHGATE AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015
Mailing Address - Country:US
Mailing Address - Phone:650-991-6680
Mailing Address - Fax:650-755-9803
Practice Address - Street 1:45 SOUTHGATE AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:DALY CITY
Practice Address - State:CA
Practice Address - Zip Code:94015
Practice Address - Country:US
Practice Address - Phone:650-991-6680
Practice Address - Fax:650-755-9803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHHA70027GMedicaid
CAHHA70027GMedicaid