Provider Demographics
NPI:1598820003
Name:ALLIANCE OCCUPATIONAL MEDICINE
Entity Type:Organization
Organization Name:ALLIANCE OCCUPATIONAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOVIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-228-0455
Mailing Address - Street 1:2737 WALSH AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-0965
Mailing Address - Country:US
Mailing Address - Phone:408-228-8400
Mailing Address - Fax:408-228-8401
Practice Address - Street 1:2737 WALSH AVE
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-0965
Practice Address - Country:US
Practice Address - Phone:408-228-8400
Practice Address - Fax:408-228-8401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG68563261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine