MEDICARE: SANTA CLARA VALLEY MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital

General Provider Information

NPI Number	:	1164665618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SANTA CLARA VALLEY MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1607 PARKMOOR AVE
Second Line	:	APARTMENT 228
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2437
Country	:	US
Telephone Number	:	408-513-4901
Fax Number	:

Provider Business Practice Location Address
First Line	:	1607 PARKMOOR AVE
Second Line	:	APARTMENT 228
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2437
Country	:	US
Telephone Number	:	408-513-4901
Fax Number	:

Authorized Official
Title or Position	:	RESIDENCY PROGRAM DIRECTOR
Name	:	DR. STEVE ROEY
Credential	:	M.D.
Telephone Number	:	408-885-7724

Provider Enumeration Date	:	04/14/2009
Last Update Date	:	04/14/2009

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