Healthcare Provider Details
I. General information
NPI: 1790949972
Provider Name (Legal Business Name): TOBIAS GODFREY HAYS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/16/2008
Last Update Date: 06/28/2022
Certification Date: 06/28/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6475 CAMDEN AVE SUITE 107
SAN JOSE CA
95120-2846
US
IV. Provider business mailing address
6475 CAMDEN AVE SUITE 107
SAN JOSE CA
95120-2846
US
V. Phone/Fax
- Phone: 408-268-4900
- Fax: 408-268-2431
- Phone: 408-268-4900
- Fax: 408-268-2431
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | A97503 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: