Healthcare Provider Details

I. General information

NPI: 1245228154
Provider Name (Legal Business Name): ADVANCED MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 BRANHAM LN A10
SAN JOSE CA
95118-2256
US

IV. Provider business mailing address

1700 BRANHAM LN A10
SAN JOSE CA
95118-2256
US

V. Phone/Fax

Practice location:
  • Phone: 408-264-6644
  • Fax: 408-264-3515
Mailing address:
  • Phone: 408-264-6644
  • Fax: 408-264-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. BRIAN EDWARD COYLE
Title or Position: PRESIDENT
Credential: DC
Phone: 408-264-6644