Provider Demographics
NPI:1689641797
Name:HOSPITAL DRIVE PEDIATRICS INC
Entity Type:Organization
Organization Name:HOSPITAL DRIVE PEDIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:MCPHERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-968-6033
Mailing Address - Street 1:2500 HOSPITAL DR
Mailing Address - Street 2:BLDG 12
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4106
Mailing Address - Country:US
Mailing Address - Phone:650-968-6033
Mailing Address - Fax:650-968-4542
Practice Address - Street 1:2500 HOSPITAL DR
Practice Address - Street 2:BLDG 12
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-968-6033
Practice Address - Fax:650-968-4542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty