Healthcare Provider Details

I. General information

NPI: 1174010771
Provider Name (Legal Business Name): AMRITHA PARTHASARATHY DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2018
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 SAMARITAN CT STE S
SAN JOSE CA
95124-4002
US

IV. Provider business mailing address

2512 SAMARITAN CT STE S
SAN JOSE CA
95124-4002
US

V. Phone/Fax

Practice location:
  • Phone: 408-657-5620
  • Fax: 408-657-5282
Mailing address:
  • Phone: 86-575-6204
  • Fax: 408-657-5282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberW7103
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberOS23267
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number20A17912
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: