Healthcare Provider Details

I. General information

NPI: 1649296393
Provider Name (Legal Business Name): JENNY H. SAW, M.D., PROFESSIONAL MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 06/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JOSE FIGUERES AVE STE 455
SAN JOSE CA
95116-1596
US

IV. Provider business mailing address

200 JOSE FIGUERES AVE STE 455
SAN JOSE CA
95116-1596
US

V. Phone/Fax

Practice location:
  • Phone: 408-923-8522
  • Fax: 408-923-8709
Mailing address:
  • Phone: 408-923-8522
  • Fax: 408-923-8709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA66727
License Number StateCA

VIII. Authorized Official

Name: DR. JENNY HTAY-HTAY-THAN SAW-HSIAO
Title or Position: PEDIATRICIAN, CEO
Credential: M.D.,
Phone: 408-923-8522