DR. PETER ALBERT ELLIOTT (NPI# 1063857597) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063857597 |
| Entity Type | Individual |
| Full Name | DR. PETER ALBERT ELLIOTT |
| Credential | MD |
| Practice Address |
751 S Bascom Ave San Jose CA 95128-2604 |
| Mailing Address |
751 S Bascom Ave Fl 4 San Jose CA 95128-2604 |
| Practice Telephone | 4088855000 |
| Mailing Telephone | 4088852670 |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2020-10-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | A134837 | CA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2121 Santa Monica Blvd, Santa Monica, CA 90404 | 3105827137 | |
| 4733 W Sunset Blvd, Fl 3, Los Angeles, CA 900276021 | 4154979007 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891060869 | Peter Ross Elliott | Social Worker | 15380 Monica St, Detroit, MI 48238-1942 | 2012-03-09 |
| 1053930149 | Peter Joseph Elliott | Pharmacist | 3221 Se 14th St, Des Moines, IA 50320-1304 | 2020-04-09 |
| 1437402526 | Peter Ryan Elliott | Specialist/Technologist | 3200 Medical Center East South Tower, Suite 3200, Nashville, TN 37232-0001 | 2012-10-26 |
| 1487660411 | Peter J Elliott | Obstetrics & Gynecology | 855 Montgomery St, Dept of Ob/gyn, Fort Worth, TX 76107-2553 | 2006-07-31 |
| 1619900842 | Peter C Elliott | Emergency Medicine | 1400 E Boulder St, Colorado Springs, CO 80909 | 2006-07-09 |
| Street Address |
751 S BASCOM AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-2604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396743217 | Ellen Perez Travis | Nurse Practitioner | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2005-07-13 |
| 1235738691 | Alina Bogdanovich | Registered Nurse | 751 S Bascom Ave, San Jose, CA 95128-2699 | 2020-10-17 |
| 1255946380 | Kimberly Red Soria | Nurse Practitioner | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-09-15 |
| 1568072403 | Emily Win Hou | Pharmacist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-08-05 |
| 1649880063 | Katherine Ann Trescott | Speech-Language Pathologist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-08-01 |
| 1992320386 | Gino Dizon Legaspi | Physical Therapy Assistant | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-06-11 |
| 1215552732 | Emily Louise Masad | Physician Assistant | 751 S Bascom Ave, San Jose, CA 95128-2699 | 2020-06-10 |
| 1790300341 | Laura Muzzatti | Physical Therapist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-06-09 |
| 1679195085 | Raymond Chao | Pharmacist | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-05-08 |
| 1407476765 | Yoo Jung Kim | Student in an Organized Health Care Education/Training Program | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2020-04-16 |
| Find all providers in the same location | ||||
| 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 | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457611048 | Naveen Yadav | Urology | 250 Hospital Pkwy Bldg B, San Jose, CA 95119-1103 | 2012-05-17 |
| 1912070889 | David Mark Nudell | Urology | 2581 Samaritan Drive, San Jose, CA 95124 | 2006-11-16 |
| 1972558666 | Edward Wang | Urology | 175 N Jackson Ave Ste 206, San Jose, CA 95116-1909 | 2006-05-23 |
| 1851341655 | Han P Lo | Urology | 75 N Bascom Ave Ste 210, San Jose, CA 95128-1802 | 2006-05-11 |
| 1447244785 | Terrence R Sullivan | Urology | 2110 Forest Ave, #c, San Jose, CA 95128-1469 | 2005-09-01 |
| 1225331770 | Urological Surgeons of Northern California | Urology | 2110 Forest Ave, Suite C, San Jose, CA 95128-1469 | 2010-12-06 |
| 1043513591 | Urological Surgeons of Northern California | Urology | 2581 Samaritan Dr, Suite 200, San Jose, CA 95124-4113 | 2010-12-06 |
| 1770886210 | Urological Surgeons of Northern California | Urology | 2505 Samaritan Dr, Suite 201, San Jose, CA 95124-4006 | 2010-12-06 |
| 1003118290 | Urological Surgeons of Northern California | Urology | 123 Di Salvo Ave, Suite D, San Jose, CA 95128-1717 | 2010-11-22 |
| 1982906178 | Urological Surgeons of Northern California | Urology | 25 N 14th St, San Jose, CA 95112-6204 | 2010-11-22 |
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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.