Healthcare Provider Details

I. General information

NPI: 1942497763
Provider Name (Legal Business Name): SAN JOSE EAR AND SINUS MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 11/13/2024
Certification Date: 11/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14981 NATIONAL AVE STE 5
LOS GATOS CA
95032-2600
US

IV. Provider business mailing address

14981 NATIONAL AVE STE 5
LOS GATOS CA
95032-2600
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-8507
  • Fax: 408-358-8506
Mailing address:
  • Phone: 408-358-8507
  • Fax: 408-358-8506

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0901X
TaxonomyOtology & Neurotology Physician
License Number
License Number State

VIII. Authorized Official

Name: HAMED SAJJADI
Title or Position: CEO
Credential:
Phone: 408-358-8507