Healthcare Provider Details

I. General information

NPI: 1659708113
Provider Name (Legal Business Name): CHASE LAY MD & ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2013
Last Update Date: 09/30/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SAMARITAN DR STE F
SAN JOSE CA
95124-4104
US

IV. Provider business mailing address

2550 SAMARITAN DR STE F
SAN JOSE CA
95124-4104
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-3888
  • Fax: 408-358-3150
Mailing address:
  • Phone: 408-358-3888
  • Fax: 408-358-3150

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YX0007X
TaxonomyPlastic Surgery within the Head & Neck (Otolaryngology) Physician
License NumberA112118
License Number StateCA

VIII. Authorized Official

Name: DR. PATRICK CHASE LAY
Title or Position: OWNER
Credential: M.D.
Phone: 408-358-3888