Healthcare Provider Details

I. General information

NPI: 1215003462
Provider Name (Legal Business Name): STEVEN N BATANIDES MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. STEVEN N BATANIDES
Title or Position: OWNER
Credential: MD
Phone: 408-255-7077