MEDICARE: SILICON VALLEY INTERNIST GROUP, INC

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	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20A9636	OTHER	CA	LICENSE

General Provider Information

NPI Number	:	1184998122
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILICON VALLEY INTERNIST GROUP, INC

Provider Business Mailing Address
First Line	:	4945 PALEMETTO DUNES CT
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95138-2131
Country	:	US
Telephone Number	:	408-772-7970
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 JOSE FIGUERES AVE STE 180
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95116-1586
Country	:	US
Telephone Number	:	408-258-5083
Fax Number	:	408-258-4347

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	TAM HOANG NGUYEN
Credential	:
Telephone Number	:	408-258-5083

Provider Enumeration Date	:	03/07/2012
Last Update Date	:	09/12/2018

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