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NPI Code Detail

MEDICARE: SAN JOSE GASTROENTEROLOGY, INC.

MEDICARE: SAN JOSE GASTROENTEROLOGY, 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
1207RG0100XGastroenterology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1578586731
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAN JOSE GASTROENTEROLOGY, INC.
Provider Business Mailing Address
First Line : 2331 MONTPELIER DR STE B
Second Line :
City : SAN JOSE
State : CA
Zip : 95116-1673
Country : US
Telephone Number : 408-347-9001
Fax Number : 408-347-9004
Provider Business Practice Location Address
First Line : 2331 MONTPELIER DR STE B
Second Line :
City : SAN JOSE
State : CA
Zip : 95116-1673
Country : US
Telephone Number : 408-347-9001
Fax Number : 408-347-9004
Authorized Official
Title or Position : BUSINESS DIRECTOR
Name : DR. HUY NGOC TRINH
Credential : M.D.
Telephone Number : 408-347-9001
Provider Enumeration Date : 07/26/2006
Last Update Date : 07/29/2022

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