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General NPI Number Information
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NPI Number | 1952794109
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Entity Type | Organization
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Legal Business Name | SAN JOSE AMBULATORY SURGERY CENTER,LP
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Dates
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Enumeration Date | 03/12/2015
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Last Update Date | 12/16/2021
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Provider Practice Location Address
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Address Line | 1174 CASTRO ST SUITE 201
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2568
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Country | US
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Telephone | 650-691-9435
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Fax |
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Provider Business Mailing Address
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Address Line | 1174 CASTRO ST SUITE 201
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2568
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SR. VICE PRESIDENT
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Name | GREGG MILLER
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Credential | MD
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Telephone | 610-644-8900
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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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