Provider Demographics
NPI:1558097279
Name:SUNOL HILLS LLC
Entity Type:Organization
Organization Name:SUNOL HILLS LLC
Other - Org Name:MID-PENINSULA EATING DISORDER CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARMOHINDER
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:ATHWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-651-5808
Mailing Address - Street 1:23 CARVER LN
Mailing Address - Street 2:
Mailing Address - City:SUNOL
Mailing Address - State:CA
Mailing Address - Zip Code:94586-9441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:21721 GRANADA AVE
Practice Address - Street 2:
Practice Address - City:CUPERTINO
Practice Address - State:CA
Practice Address - Zip Code:95014-5934
Practice Address - Country:US
Practice Address - Phone:650-319-7225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUNOL HILLS LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-07-26
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty