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General NPI Number Information
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NPI Number | 1487850350
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Entity Type | Organization
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Legal Business Name | SAMARITAN PLASTIC SURGERY CENTER, INC
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2550 SAMARITAN DR
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City | SAN JOSE
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State | CA
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Zip | 95124-4104
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Country | US
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Telephone | 408-358-3164
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Fax | 408-358-1088
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Provider Business Mailing Address
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Address Line | 2550 SAMARITAN DR
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City | SAN JOSE
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State | CA
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Zip | 95124-4104
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Country | US
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Telephone | 408-358-3164
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Fax | 408-358-1088
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. GAETON NOLA
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Credential | MD
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Telephone | 408-358-3164
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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