Provider Demographics
NPI:1669069118
Name:SATELLITE HEALTHCARE OF NORTH TRACY, LLC
Entity type:Organization
Organization Name:SATELLITE HEALTHCARE OF NORTH TRACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:L
Authorized Official - Last Name:WEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-736-2700
Mailing Address - Street 1:300 SANTANA ROW STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2424
Mailing Address - Country:US
Mailing Address - Phone:669-236-5947
Mailing Address - Fax:650-625-6007
Practice Address - Street 1:1005 N PESCADERO AVENUE
Practice Address - Street 2:SUITE 201-207
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95304-8507
Practice Address - Country:US
Practice Address - Phone:669-236-5947
Practice Address - Fax:650-625-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-30
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QE0700XAmbulatory Health Care FacilitiesClinic/CenterEnd-Stage Renal Disease (ESRD) Treatment