Healthcare Provider Details

I. General information

NPI: 1073404562
Provider Name (Legal Business Name): CALIFORNIA EAR, NOSE & THROAT INSTITUTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2025
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 HOSPITAL DR STE 205
MOUNTAIN VIEW CA
94040-4124
US

IV. Provider business mailing address

2490 HOSPITAL DR STE 205
MOUNTAIN VIEW CA
94040-4124
US

V. Phone/Fax

Practice location:
  • Phone: 650-880-1088
  • Fax: 650-880-1088
Mailing address:
  • Phone: 650-880-1088
  • Fax: 650-880-1088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. FLAVIO OLIVEIRA
Title or Position: OWNER
Credential: MD, PHD
Phone: 650-880-1088