EVERGREEN SURGERY CENTER, LLC (NPI# 1538618368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538618368 |
| Entity Type | Organization |
| Organization Name | EVERGREEN SURGERY CENTER, LLC |
| Practice Address |
2365 Quimby Rd Ste 180 San Jose CA 95122-1337 |
| Practice Telephone | 4086205675 |
| Practice Fax Number | 4082231534 |
| Mailing Telephone | 4086205675 |
| Mailing Fax Number | 4082231534 |
| Enumeration Date | 2016-09-21 |
| Last Update Date | 2019-02-04 |
| Authorized Official Name | DR. HECTOR CERVANTES (PARTNER) |
| Authorized Official Telephone | 4086205723 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689655334 | Evergreen Surgery Center, LLC | Clinic/Center | 12333 Ne 130th Ln, Suite 500, Kirkland, WA 98034-7467 | 2005-11-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | EVERGREEN SURGERY CENTER, LLC | 12040 Ne 128th St, Attn: Kcphd#2 D/b/a Evergreenhealth, Kirkland, WA 98034-3013 |
| Street Address |
2365 QUIMBY RD STE 180 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95122-1337 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437788015 | Vietnam Pharmacy Inc | Pharmacy | 2451 S King Rd Suite A1, San Jose, CA 95122 | 2020-04-06 |
| 1346894524 | Amy Le Tran | Counselor | Mekong Community Center, 2203 Tully Road, San Jose, CA 95122 | 2019-07-26 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1740761196 | Aileen Phu | Acupuncturist | 1271 Story Rd Ste 50, San Jose, CA 95122 | 2018-08-23 |
| 1740775816 | Urgent Care Clinic of Northern Ca Inc | Clinic/Center | 999 Story Road, Suite 9021, San Jose, CA 95122 | 2018-06-29 |
| 1952825911 | Robert Martin Thomas | Counselor | 950 Julian St, San Jose, CA 95122 | 2017-08-01 |
| 1497113153 | Jamealle Spain | Case Manager/Care Coordinator | 2070 Lucretia Ave #310, San Jose, CA 95122 | 2016-02-09 |
| 1770915035 | Thinh Tran | Dentist | 919 Story Rd Unit 1128, San Jose, CA 95122 | 2013-08-08 |
| 1356591333 | Asian American Recovery Services | Counselor | 1340 Tully Rd., San Jose, CA 95122 | 2008-09-25 |
| 1821246505 | Samara Rachel Stone | Marriage & Family Therapist | 1340 Tully Road, Suite 304, San Jose, CA 95122 | 2008-09-05 |
| Find all providers in zip 95122 | ||||
| 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 |
| 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 |
| 1194712109 | Executive Endoscopy, Inc | Clinic/Center | 2100 Forest Ave, 109, San Jose, CA 95128-1422 | 2005-10-04 |
| 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.