Healthcare Provider Details

I. General information

NPI: 1982906178
Provider Name (Legal Business Name): UROLOGICAL SURGEONS OF NORTHERN CALIFORNIA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2010
Last Update Date: 11/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N 14TH ST
SAN JOSE CA
95112-6204
US

IV. Provider business mailing address

PO BOX 6971
LINCOLN NE
68506-0971
US

V. Phone/Fax

Practice location:
  • Phone: 408-998-1877
  • Fax:
Mailing address:
  • Phone: 402-486-7006
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID HC KING
Title or Position: PRESIDENT
Credential: MD
Phone: 408-866-2500