Healthcare Provider Details

I. General information

NPI: 1700864162
Provider Name (Legal Business Name): HEART ASSOCIATES OF NORTHERN CALIF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2581 SAMARITAN DR STE 202
SAN JOSE CA
95124-4112
US

IV. Provider business mailing address

2581 SAMARITAN DR STE 202
SAN JOSE CA
95124-4112
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-3939
  • Fax: 408-358-3797
Mailing address:
  • Phone: 408-358-3939
  • Fax: 408-358-3797

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SUE ALVEY
Title or Position: MANAGER
Credential:
Phone: 408-358-3939