Healthcare Provider Details

I. General information

NPI: 1174773865
Provider Name (Legal Business Name): HEART AND VASCULAR MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2008
Last Update Date: 09/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 GRANT RD
MOUNTAIN VIEW CA
94040-4308
US

IV. Provider business mailing address

2490 HOSPITAL DR #311
MOUNTAIN VIEW CA
94040-4122
US

V. Phone/Fax

Practice location:
  • Phone: 650-969-8600
  • Fax:
Mailing address:
  • Phone: 650-969-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES DAVID JOYE
Title or Position: PRESIDENT
Credential: D.O.
Phone: 650-969-8600