Healthcare Provider Details

I. General information

NPI: 1528203338
Provider Name (Legal Business Name): UROLOGICAL SURGEONS OF NORTHERN CALIFORNIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2008
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 SAMARITAN DR
SAN JOSE CA
95124-3907
US

IV. Provider business mailing address

320 DARDANELLI LANE SUITE 23B
LOS GATOS CA
95032
US

V. Phone/Fax

Practice location:
  • Phone: 650-962-4662
  • Fax: 650-962-4652
Mailing address:
  • Phone: 408-866-2500
  • Fax: 408-866-2469

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID H.C. KING
Title or Position: PRESIDENT
Credential: M.D.
Phone: 408-866-2500