PET IMAGING OF SAN JOSE, LLC (NPI# 1477693513) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477693513 |
| Entity Type | Organization |
| Organization Name | PET IMAGING OF SAN JOSE, LLC |
| Practice Address |
2211 Moorpark Ave Suite 220 San Jose CA 95128-2654 |
| Practice Telephone | 4082978844 |
| Practice Fax Number | 4082978220 |
| Mailing Telephone | 4082978844 |
| Mailing Fax Number | 4082978220 |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-04-24 |
| Authorized Official Name | BIJAN FARHANGUI (CEO, PRESIDENT) |
| Authorized Official Telephone | 4082978844 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QR0200X |
Clinic/Center Specialization: Radiology |
Ambulatory Health Care Facilities | ||
| Y | 305R00000X | Preferred Provider Organization | 6846-43 | CA | Managed Care Organizations |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629187695 | Pet Imaging of San Jose, LLC | Specialist | 2211 Moorpark Ave., Suite 220, San Jose, CA 95128-2632 | 2006-08-30 |
| Street Address |
2211 MOORPARK AVE SUITE 220 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-2654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841283850 | Center for Independent Rehabilitative Services, Inc. | Prosthetic/Orthotic Supplier | 2211 Moorpark Ave, Ste. 230, San Jose, CA 95128-2654 | 2005-08-24 |
| 1306291414 | Wellness Chiropractic Center | Clinic/Center | 2211 Moorpark Ave, Suite 280, San Jose, CA 95128-2654 | 2016-04-26 |
| 1265812309 | Ki Tae Kim Chiropractic Inc. | Clinic/Center | 2211 Moorpark Ave, Suite 280, San Jose, CA 95128-2654 | 2015-06-04 |
| 1326432402 | Sewon Kim | Acupuncturist | 2211 Moorpark Ave, Suite 250, San Jose, CA 95128-2654 | 2015-03-26 |
| 1164780086 | Desiree Mehrabian | Registered Nurse | 2211 Moorpark Ave, Suite 218, San Jose, CA 95128-2654 | 2012-04-28 |
| 1548527310 | Ruth Anne Mitchell | Registered Nurse | 2211 Moorpark Ave, Suite 218, San Jose, CA 95128-2654 | 2012-04-18 |
| 1275899486 | Victor Cheng | Acupuncturist | 2211 Moorpark Ave, Suite 250, San Jose, CA 95128-2654 | 2012-04-02 |
| 1184904518 | Medpixels Medical Services, PC | Clinic/Center | 2211 Moorpark Ave, Suite 290, San Jose, CA 95128-2663 | 2011-08-17 |
| 1588985139 | Kelley C Kim | Dietitian, Registered | 2211 Moorpark Ave, Suite 218, San Jose, CA 95128-2654 | 2010-06-17 |
| 1912224221 | Ron Rosen, M.d., Inc | Interpreter | 2211 Moorpark Ave, Suite 220, San Jose, CA 95128-2654 | 2010-04-26 |
| 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 | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609297878 | Health Connection Chiropractic | Preferred Provider Organization | 2801 Moorpark Ave Ste 2, San Jose, CA 95128-3103 | 2013-12-13 |
| 1699100313 | Toothscaler Dental | Preferred Provider Organization | 2090 N Capitol Ave Ste D, San Jose, CA 95132-1017 | 2013-09-12 |
| 1528238615 | Tuyen Quang Nguyen D.d.s, Inc. | Preferred Provider Organization | 634 E Santa Clara St, San Jose, CA 95112-1902 | 2008-03-05 |
| 1588782205 | Better Health Clinic | Preferred Provider Organization | 1072 S De Anza Blvd, A-108, San Jose, CA 95129-3500 | 2007-03-27 |
| 1922455575 | Adrienne Ngoc Lan Van, Dds, Inc. | Preferred Provider Organization | 2114 Senter Rd, Ste 14, San Jose, CA 95112-2608 | 2016-05-24 |
| 1679931521 | Heart & Rhythm Clinic, A Professional Medical Corporation | Preferred Provider Organization | 105 N Bascom Ave, Suite 204, San Jose, CA 95128-1811 | 2016-02-08 |
| 1134520943 | Lluan T. Le, Dds, Inc | Preferred Provider Organization | 3151 S White Rd, Ste 204, San Jose, CA 95148-4045 | 2014-09-11 |
| 1427469287 | Darshini Shah Dds Inc. | Preferred Provider Organization | 2652 Alum Rock Ave Ste A, San Jose, CA 95116-2663 | 2014-05-14 |
| 1831335579 | Susan Thuyminh Lee D.d.s. Inc | Preferred Provider Organization | 2726 Aborn Rd, San Jose, CA 95121-1276 | 2008-12-31 |
| 1417128638 | Ninh Anh Dao Dds, Inc | Preferred Provider Organization | 2830 S White Rd, San Jose, CA 95148-2932 | 2008-03-15 |
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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.