Healthcare Provider Details

I. General information

NPI: 1194897298
Provider Name (Legal Business Name): STEVEN N BATANIDES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 GRAVES AVE SUITE 11B
SAN JOSE CA
95129-5013
US

IV. Provider business mailing address

5150 GRAVES AVE SUITE 11B
SAN JOSE CA
95129-5013
US

V. Phone/Fax

Practice location:
  • Phone: 408-255-7077
  • Fax: 408-855-5568
Mailing address:
  • Phone: 408-255-7077
  • Fax: 408-855-5568

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberG30145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: