Healthcare Provider Details

I. General information

NPI: 1396703179
Provider Name (Legal Business Name): VALLEY RADIOLOGY MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 07/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2281 PARAGON DR SUITE 400
SAN JOSE CA
95131-1307
US

IV. Provider business mailing address

2281 PARAGON DR
SAN JOSE CA
95131-1307
US

V. Phone/Fax

Practice location:
  • Phone: 408-961-2649
  • Fax: 408-244-6596
Mailing address:
  • Phone: 408-961-2649
  • Fax: 408-244-6596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MARIA MATSUMOTO
Title or Position: PRESIDENT
Credential: M.D.
Phone: 408-244-2100