Healthcare Provider Details
I. General information
NPI: 1457565756
Provider Name (Legal Business Name): SURGERY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2450 SAMARITAN DR
SAN JOSE CA
95124-3912
US
IV. Provider business mailing address
2450 SAMARITAN DR
SAN JOSE CA
95124-3912
US
V. Phone/Fax
- Phone: 408-358-1855
- Fax: 408-356-4183
- Phone: 408-358-1855
- Fax: 408-356-4183
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2086H0002X |
| Taxonomy | Hospice and Palliative Medicine (Surgery) Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
JEFFREY
E
DOTY
Title or Position: PARTNER
Credential: M.D.
Phone: 408-358-1855