Healthcare Provider Details

I. General information

NPI: 1962575852
Provider Name (Legal Business Name): REGIONAL MEDICAL CENTER OF SAN JOSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N JACKSON AVE
SAN JOSE CA
95116-1603
US

IV. Provider business mailing address

2628 MORAINE DR
SANTA CLARA CA
95051-1120
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-5000
  • Fax:
Mailing address:
  • Phone: 408-249-4791
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA96234
License Number StateCA

VIII. Authorized Official

Name: DR. NATASA POPOVIC
Title or Position: MD
Credential:
Phone: 408-259-5000