Healthcare Provider Details

I. General information

NPI: 1356518526
Provider Name (Legal Business Name): PHIROZE KAZI MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2008
Last Update Date: 10/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 SAMARITAN DR SUITE 304
SAN JOSE CA
95124-4006
US

IV. Provider business mailing address

2505 SAMARITAN DR SUITE 304
SAN JOSE CA
95124-4006
US

V. Phone/Fax

Practice location:
  • Phone: 408-358-3585
  • Fax: 408-358-3587
Mailing address:
  • Phone: 408-358-3585
  • Fax: 408-358-3587

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberA63532
License Number StateCA

VIII. Authorized Official

Name: SHEHNAZ KAZI
Title or Position: OFFICE MANAGER
Credential:
Phone: 408-358-3585