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General NPI Number Information
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NPI Number | 1619630381
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Entity Type | Organization
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Legal Business Name | VLADIMIR SKOROKHOD MD CORPORATION
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Dates
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Enumeration Date | 10/19/2021
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Last Update Date | 10/19/2021
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Provider Practice Location Address
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Address Line | 5912 MOUNTAIN MEADOW CT
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City | SAN JOSE
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State | CA
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Zip | 95135-1655
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Country | US
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Telephone | 559-827-6130
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Fax |
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Provider Business Mailing Address
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Address Line | 5912 MOUNTAIN MEADOW CT
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City | SAN JOSE
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State | CA
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Zip | 95135-1655
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Country | US
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Telephone | 559-827-6130
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | VLADIMIR SKOROKHOD
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Credential | MD
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Telephone | 415-867-6104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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