Healthcare Provider Details

I. General information

NPI: 1508790619
Provider Name (Legal Business Name): JSVN MEDICAL INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2026
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4859 SCOTTS VALLEY DR STE A
SCOTTS VALLEY CA
95066-4218
US

IV. Provider business mailing address

4859 SCOTTS VALLEY DR STE A
SCOTTS VALLEY CA
95066-4218
US

V. Phone/Fax

Practice location:
  • Phone: 831-215-3500
  • Fax: 831-215-3600
Mailing address:
  • Phone: 831-215-3500
  • Fax: 831-215-3600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: TUONG NGUYEN VU
Title or Position: FOUNDER
Credential: MD
Phone: 831-215-3500