MICHAEL HENEHAN (NPI# 1053497685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053497685 |
| Entity Type | Individual |
| Full Name | MICHAEL HENEHAN |
| Credential | D.O. |
| Practice Address |
455 Oconnor Dr Ste 210 San Jose CA 95128-1633 |
| Practice Telephone | 4089955453 |
| Practice Fax Number | 4082759442 |
| Mailing Telephone | 4089955453 |
| Mailing Fax Number | 4082759442 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2012-02-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
20A4724 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
455 OCONNOR DR STE 210 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-1633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609861400 | Aldon J Hilton | Dentist | 455 Oconnor Dr, Suite 320, San Jose, CA 95128-1633 | 2005-09-17 |
| 1245850585 | Celina Allyn Mercer | Student in an Organized Health Care Education/Training Program | 455 Oconnor Dr, San Jose, CA 95128-1633 | 2020-04-16 |
| 1255820635 | Alexandra Laura Duisberg | Student in an Organized Health Care Education/Training Program | 455 Oconnor Dr, San Jose, CA 95128-1633 | 2018-05-01 |
| 1457857831 | William Chun-yin Hui | Student in an Organized Health Care Education/Training Program | 455 Oconnor Dr, San Jose, CA 95128-1633 | 2018-04-04 |
| 1760910467 | Lucia Tome | Family Medicine | 455 Oconnor Dr, San Jose, CA 95128-1633 | 2017-05-25 |
| 1972985083 | O'connor Hospital | General Acute Care Hospital | 455 Oconnor Dr, Suite 200, San Jose, CA 95128-1633 | 2015-06-25 |
| 1790167401 | Angela F Chiang | Student in an Organized Health Care Education/Training Program | 455 Oconnor Dr, Suite 200, San Jose, CA 95128-1633 | 2015-06-18 |
| 1386026086 | Nhat Pham | Student in an Organized Health Care Education/Training Program | 455 Oconnor Dr, Ste 200, San Jose, CA 95128-1633 | 2015-06-18 |
| 1396123568 | Sutter Visiting Nurse Association and Hospice | Clinic/Center | 455 Oconnor Dr, Suite 300, San Jose, CA 95128-1633 | 2015-05-08 |
| 1194139253 | David Shin | Family Medicine | 455 Oconnor Dr, Suite 250, San Jose, CA 95128 | 2014-06-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225087984 | Robert S Nishime | Family Medicine | 280 Jackson St, San Jose, CA 95112-3256 | 2006-05-09 |
| 1083142582 | Marisa Yanez Jayakar | Family Medicine | 455 Oconnor Dr Ste 210, San Jose, CA 95128-1632 | 2017-05-27 |
| 1194139253 | David Shin | Family Medicine | 455 Oconnor Dr, Suite 250, San Jose, CA 95128 | 2014-06-17 |
| 1306281225 | Naomi Lena Koester | Family Medicine | 2400 Moorpark Ave Ste 300, San Jose, CA 95128 | 2013-05-06 |
| 1124230008 | Robert Laurence Kronisch | Family Medicine | San Jose State University Student Health Ctr, One Washington Square, San Jose, CA 95192-0037 | 2007-05-04 |
| 1689623498 | Robert S Nishime Md Inc | Family Medicine | 280 Jackson St, San Jose, CA 95112-3256 | 2006-05-09 |
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|---|---|---|---|---|
| 1447875570 | Nader Sobh Inc | Family Medicine | 11740 San Vicente Blvd Ste 205, Los Angeles, CA 90049-6610 | 2020-06-15 |
| 1124596010 | Cam Md | Family Medicine | 1968 S Coast Hwy # 401, Laguna Beach, CA 92651-3681 | 2018-11-08 |
| 1902289226 | Daesoon Leem | Family Medicine | 15095 Amargosa Rd, Bldg.1, #102, Victorville, CA 92394 | 2015-07-06 |
| 1114313616 | Michelle Sriwongtong | Family Medicine | 834 Castro St, 3, San Francisco, CA 94114-2858 | 2015-04-10 |
| 1225433006 | Harut Madatovian | Family Medicine | 2595 E Washington Blvd Ste 106, Pasadena, CA 91107-1409 | 2014-10-23 |
| 1760801880 | Kyle William Meyer | Family Medicine | 24910 Las Brisas Rd Ste 105, Murrieta, CA 92562 | 2014-04-16 |
| 1720403553 | Dianne Longo | Family Medicine | 1319 Evergreen Ave, Apt N2, Fullerton, CA 92835-2063 | 2014-03-03 |
| 1255760633 | Steven William Marles | Family Medicine | 4265 Tapestry Way, Turlock, CA 95382-7448 | 2013-11-05 |
| 1497098909 | Joshua David Sampson | Family Medicine | 2299 Post St Ste 107, San Francisco, CA 94115-3460 | 2013-04-03 |
| 1699015529 | Andrew Saleh | Family Medicine | 1370 Rosecrans St Ste A, San Diego, CA 92106-2676 | 2013-03-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.