Healthcare Provider Details
I. General information
NPI: 1124799572
Provider Name (Legal Business Name): MAUNG PATEL OMS PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/24/2021
Last Update Date: 06/19/2025
Certification Date: 06/19/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1150 SCOTT BLVD STE D1
SANTA CLARA CA
95050-4547
US
IV. Provider business mailing address
1150 SCOTT BLVD STE D1
SANTA CLARA CA
95050-4547
US
V. Phone/Fax
- Phone: 408-248-9597
- Fax: 408-248-9590
- Phone: 408-248-9597
- Fax: 408-248-9590
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 204E00000X |
| Taxonomy | Oral & Maxillofacial Surgery (D.M.D.) |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
LINN
H
MAUNG
Title or Position: OWNER
Credential: MD
Phone: 510-220-5349