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General NPI Number Information
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NPI Number | 1609430065
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Entity Type | Organization
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Legal Business Name | GILROY MEDICAL GROUP, INC
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Dates
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Enumeration Date | 04/30/2019
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Last Update Date | 04/30/2019
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Provider Practice Location Address
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Address Line | 8833 MONTEREY RD STE H
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City | GILROY
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State | CA
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Zip | 95020-7200
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Country | US
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Telephone | 408-842-1544
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 LAFAYETTE ST
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City | SANTA CLARA
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State | CA
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Zip | 95050-2904
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Country | US
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Telephone | 408-307-0560
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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. DONALD SIAO
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Credential | MD
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Telephone | 408-206-0217
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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 |
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License Number State |
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