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General NPI Number Information
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NPI Number | 1538981865
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Entity Type | Organization
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Legal Business Name | CAMNY MEDICAL SERVICES WEST PC
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Dates
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Enumeration Date | 10/28/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 99 SOUTH ALMADEN BLVD SUITE 600
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City | SAN JOSE
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State | CA
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Zip | 95113
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Country | US
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Telephone | 888-383-5881
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Fax |
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Provider Business Mailing Address
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Address Line | 99 SOUTH ALMADEN BLVD SUITE 600
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City | SAN JOSE
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State | CA
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Zip | 95113
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Country | US
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Telephone | 888-383-5881
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Fax |
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Authorized Official
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Title or Position | OPERATIONS ADMINISTRATOR
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Name | DR. KRISTINE I MCCOY
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Credential | MD
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Telephone | 888-383-5881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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