South Drive Medical Clinic

LBN: South Drive Medical Clinic
South Drive Medical Clinic is an health care organization with primary practice located at 515 S Drive #15, Mountain View CA 94040-4209. The organization recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Allopathic & Osteopathic Physicians / Internal Medicine. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. South Drive Medical Clinic can be contacted via phone (650) 961-9430, or through Peters, Kenneth S via phone (650) 961-9430.

Contact Information

Primary practice address
515 S Drive #15 Mountain View CA 94040-4209
Phone: (650) 961-9430
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Peters, Kenneth S Doctor of Medicine (MD)
Phone: (650) 961-9430

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY4724 California
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X G33788 California

Profile Details

NPI number 1043248560
LBN Legal business name South Drive Medical Clinic
DBA Doing business as
Authorized official Peters, Kenneth S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2006
Last updated Aug 22nd, 2020 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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