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General NPI Number Information
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NPI Number | 1023108719
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Entity Type | Organization
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Legal Business Name | SOUTH BAY RESPIRATORY ASSOCIATES
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Dates
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Enumeration Date | 10/13/2006
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Last Update Date | 01/19/2009
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Provider Practice Location Address
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Address Line | 65 N 14TH ST
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City | SAN JOSE
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State | CA
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Zip | 95112-6207
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Country | US
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Telephone | 408-279-1400
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Fax | 408-279-3216
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Provider Business Mailing Address
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Address Line | 65 N 14TH ST
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City | SAN JOSE
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State | CA
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Zip | 95112-6207
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Country | US
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Telephone | 408-279-1400
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Fax | 408-279-3216
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Authorized Official
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Title or Position | PARTNER
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Name | SYDNEY CHOSLOVSKY
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Credential | MD
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Telephone | 408-279-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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