EXECUTIVE ENDOSCOPY, INC (NPI# 1194712109) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194712109 |
| Entity Type | Organization |
| Organization Name | EXECUTIVE ENDOSCOPY, INC |
| Other Organization Name | ENDOSCOPY CENTER OF SAN JOSE |
| Practice Address |
2100 Forest Ave 109 San Jose CA 95128-1422 |
| Practice Telephone | 4082972314 |
| Practice Fax Number | 4082972414 |
| Mailing Telephone | 4082972314 |
| Mailing Fax Number | 4082972414 |
| Enumeration Date | 2005-10-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARIBEL RIVERA (OFFICE MANAGER) |
| Authorized Official Telephone | 4082972314 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | SUR01553F | 05 |
| Other Name | Type Code |
|---|---|
| Endoscopy Center of San Jose | Doing Business As Name - Organization |
| Street Address |
2100 FOREST AVE 109 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-1422 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184146714 | Mona Mukesh Joshi | Optometrist | 2100 Forest Ave, Ste 110, San Jose, CA 95128-1422 | 2017-07-14 |
| 1871712174 | Forest Avenue Medical Group | Internal Medicine | 2100 Forest Ave, Suite 104, San Jose, CA 95128-1422 | 2007-04-25 |
| 1174655633 | Michael Francis Martin | Internal Medicine | 2100 Forest Ave, Suite 104, San Jose, CA 95128-1422 | 2007-03-11 |
| 1801925151 | Thomas James Mcguire | Internal Medicine | 2100 Forest Ave, Suite 104, San Jose, CA 95128-1422 | 2007-03-05 |
| 1598815110 | Executive Endoscopy, Inc. | Clinic/Center | 2100 Forest Ave, Suite 109, San Jose, CA 95128 | 2007-01-12 |
| 1942373998 | David W Chui | Internal Medicine | 2100 Forest Ave, 102, San Jose, CA 95128-1422 | 2006-11-16 |
| 1700955143 | Michael Tandick Charney | Internal Medicine | 2100 Forest Ave, #106, San Jose, CA 95128-1422 | 2006-11-07 |
| 1639265770 | Robert Edmond Neger | Ophthalmology | 2100 Forest Ave, Suite 110, San Jose, CA 95128-1422 | 2006-10-05 |
| 1548363112 | Harold Allen Rodgers | Dermatology | 2100 Forest Ave, #103, San Jose, CA 95128-1422 | 2006-09-07 |
| 1023122959 | David H Eby Jr. | Internal Medicine | 2100 Forest Ave, Suite 104, San Jose, CA 95128 | 2006-08-18 |
| 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 | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1588131395 | Baasc | Clinic/Center | 4215 Hamilton Ave, San Jose, CA 95130-1462 | 2018-10-30 |
| 1295213734 | Los Gatos Surgical Center, A California Limited Partnership | Clinic/Center | 2410 Samaritan Dr Ste 100, San Jose, CA 95124-3909 | 2018-08-06 |
| 1538618368 | Evergreen Surgery Center, LLC | Clinic/Center | 2365 Quimby Rd Ste 180, San Jose, CA 95122-1337 | 2016-09-21 |
| 1801269121 | Silver Creek Surgery Ctr LLC | Clinic/Center | 6010 Hellyer Ave, Suite 100, San Jose, CA 95138-1014 | 2015-11-09 |
| 1891837415 | Plastic & Reconstructive Surgery Center | Clinic/Center | 2581 Samaritan Dr Ste 102, San Jose, CA 95124-4112 | 2007-02-12 |
| 1508942996 | Physicians Surgery Services Lp | Clinic/Center | 235 Oconnor Dr, San Jose, CA 95128-1624 | 2006-10-27 |
| 1568837060 | Prism | Clinic/Center | 6080 Hellyer Ave, Suite 100, San Jose, CA 95138-1052 | 2015-12-09 |
| 1770951915 | Tri-county Vascular Care, LLC | Clinic/Center | 393 Blossom Hill Rd, San Jose, CA 95123-1652 | 2015-09-03 |
| 1750789814 | Trinity Surgery Center, LLC | Clinic/Center | 1610 Blossom Hill Rd, #13, San Jose, CA 95124-6349 | 2014-12-05 |
| Find all providers in SAN JOSE | ||||
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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.