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General NPI Number Information
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NPI Number | 1487950903
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Entity Type | Organization
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Legal Business Name | PRIMARY CARE AND GERIATRICS INC
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Dates
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Enumeration Date | 01/31/2011
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Last Update Date | 04/01/2011
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Provider Practice Location Address
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Address Line | 700 W PARR AVE SUITE B
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City | LOS GATOS
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State | CA
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Zip | 95032-1442
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Country | US
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Telephone | 408-871-9100
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Fax | 408-871-9105
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Provider Business Mailing Address
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Address Line | PO BOX 321092
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City | LOS GATOS
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State | CA
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Zip | 95032-0118
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Country | US
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Telephone | 281-536-9288
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ANAKHA R NAMBIAR
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Credential | M.D
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Telephone | 281-536-9288
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C54283
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | C54283
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License Number State | CA
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