NPIMap

Organization Active NPI

Santa Cruz Medical Foundation Palo Alto Medical Foundation

Doing business as Sutter Santa Cruz Aptos

  • Non-Pharmacy Dispensing Site
  • Aptos, CA
National Provider Identifier
1053574806
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
A63459 Issued in CA
Legal business name
SANTA CRUZ MEDICAL FOUNDATION PALO ALTO MEDICAL FOUNDATION
Doing business as
Sutter Santa Cruz Aptos
Practice address
7600 Old Dominion CT
1St
Aptos, CA 95003-3821
Phone
(831) 458-6200
NPI assigned
Jul 2, 2008
Last updated
Oct 22, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDVANTX, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kenny Heine
Title
Director Operations
Phone
(858) 625-2990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X A63459 CA Primary

Addresses

Primary practice location

7600 Old Dominion CT
1St
Aptos, CA 95003-3821

Mailing address

5626 Oberlin Dr
Suite 110
San Diego, CA 92121-1705

Other names 1

  • Sutter Santa Cruz Aptos Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Palo Alto Medical Foundation2 organizations share this tax ID, including this one
Part of
Medvantx Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350864000000",
    "number": "1053574806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5626 OBERLIN DR",
            "address_2": "SUITE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 OLD DOMINION CT",
            "address_2": "1ST",
            "city": "APTOS",
            "state": "CA",
            "postal_code": "950033821",
            "telephone_number": "831-458-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANTA CRUZ MEDICAL FOUNDATION PALO ALTO MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDVANTX, INC.",
        "enumeration_date": "2008-07-02",
        "last_updated": "2012-10-22",
        "status": "A",
        "authorized_official_last_name": "HEINE",
        "authorized_official_first_name": "KENNY",
        "authorized_official_title_or_position": "DIRECTOR OPERATIONS",
        "authorized_official_telephone_number": "858-625-2990"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "A63459",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sutter Santa Cruz Aptos",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Aptos, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.