Provider Demographics
NPI:1700680147
Name:CPH-COMPREHENSIVE PEDIATRIC HEATH
Entity type:Organization
Organization Name:CPH-COMPREHENSIVE PEDIATRIC HEATH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JULLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PADAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-503-8899
Mailing Address - Street 1:3351 EL CAMINO REAL STE 205
Mailing Address - Street 2:
Mailing Address - City:ATHERTON
Mailing Address - State:CA
Mailing Address - Zip Code:94027-3864
Mailing Address - Country:US
Mailing Address - Phone:650-503-8899
Mailing Address - Fax:
Practice Address - Street 1:3351 EL CAMINO REAL STE 205
Practice Address - Street 2:
Practice Address - City:ATHERTON
Practice Address - State:CA
Practice Address - Zip Code:94027-3864
Practice Address - Country:US
Practice Address - Phone:650-503-8899
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0216XAllopathic & Osteopathic PhysiciansPediatricsPediatric RheumatologyGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty