SAN JOSE MEDICAL CLINIC, INC. (NPI# 1598841215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598841215 |
| Entity Type | Organization |
| Organization Name | SAN JOSE MEDICAL CLINIC, INC. |
| Other Organization Name | SAN JOSE MEDICAL GROUP |
| Practice Address |
625 Lincoln Ave San Jose CA 95126-3705 |
| Mailing Address |
400 Race St San Jose CA 95126-3518 |
| Practice Telephone | 4082783000 |
| Mailing Telephone | 4082783121 |
| Mailing Fax Number | 4082783194 |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2007-10-10 |
| Authorized Official Name | MR. ERNIE ANGEL WALLERSTEIN (C.E.O.) |
| Authorized Official Telephone | 4082783000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207K00000X | Allergy & Immunology | Allopathic & Osteopathic Physicians | ||
| N | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207W00000X | Ophthalmology | Allopathic & Osteopathic Physicians | ||
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207Y00000X | Otolaryngology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 213E00000X | Podiatrist | Podiatric Medicine & Surgery Service Providers | ||
| N | 363A00000X | Physician Assistant | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | YYY20328Y | 05 |
| Other Name | Type Code |
|---|---|
| San Jose Medical Group | Doing Business As Name - Organization |
| Street Address |
625 LINCOLN AVE |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95126-3705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700850708 | Brian Farris | Internal Medicine | 625 Lincoln Ave, San Jose, CA 95126-3705 | 2006-02-15 |
| 1447817309 | Liane Christine Tongol | Physician Assistant | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2019-05-24 |
| 1689014755 | Sheetal Ankolekar | Family Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2013-07-03 |
| 1902145592 | Thanh-tam Ngoc Nguyen | Family Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2013-02-03 |
| 1023360930 | Daniel Hudson Morgan | Family Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2012-10-03 |
| 1326312067 | Verity Medical Foundation | Clinic/Center | 625 Lincoln Ave, San Jose, CA 95126-3705 | 2012-02-27 |
| 1053604652 | Hd Ultrasound, LLC | Clinic/Center | 625 Lincoln Ave, Suite 201, San Jose, CA 95126-3705 | 2011-05-16 |
| 1437469129 | Steven How-han Sheh | Internal Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2010-10-14 |
| 1568503654 | Physicians Medical Group of San Jose, Inc. | Non-Pharmacy Dispensing Site | 625 Lincoln Ave, San Jose, CA 95126-3705 | 2007-02-09 |
| 1871658864 | Ruta V Wakharkar | Internal Medicine | 625 Lincoln Ave, San Jose, CA 95126-3785 | 2006-12-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356830418 | Esperanza Maravilla | Counselor | 1259 Park Ave, Apt 15, San Jose, CA 95126 | 2018-05-04 |
| 1811417819 | Sahr Lawande | Occupational Therapist | 1373 University Ave, San Jose, CA 95126 | 2017-06-21 |
| 1063941482 | Yang Li | Acupuncturist | 1520 Southwest Expy Unit 141, San Jose, CA 95126 | 2017-06-08 |
| 1598294860 | Camille Campbell | Counselor | 1400 Parkmoor Avenue, Suite 115, San Jose, CA 95126 | 2017-06-08 |
| 1588193387 | Vanessa Aspera | Case Manager/Care Coordinator | 1400 Parkmoor Avenue, San Jose, CA 95126 | 2017-06-06 |
| 1538692603 | Alexa Stine Fields | Acupuncturist | 714 Harding Ave, San Jose, CA 95126 | 2017-04-06 |
| 1669903647 | Lillette Rosete | Assisted Living Facility | 960 Vermont St, San Jose, CA 95126 | 2017-03-22 |
| 1952847105 | Dana Ninkham | Behavior Technician | 1922 The Alameda Suite 425, San Jose, CA 95126 | 2017-01-12 |
| 1811441199 | Cristina Morales Delgado | Community Health Worker | 1400 Parkmore Avenue, Suite 115, San Jose, CA 95126 | 2016-08-04 |
| 1053770123 | Felicia Nibungco | Marriage & Family Therapist | 1922 The Alameda Ste 326, San Jose, CA 95126 | 2016-02-18 |
| Find all providers in zip 95126 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457850455 | Manjari Aravamuthan,m.d.;p.c. | Internal Medicine | 1569 Lexann Ave Ste 220, San Jose, CA 95121-1795 | 2018-02-05 |
| 1841737236 | Maria Cecilia Monge Bonilla | Internal Medicine | 200 Metros Este Del Ampm, Guachipelin Escazu, San Jose, SAN JOSE 1000 | 2017-01-24 |
| 1417305624 | Pydi Akella | Internal Medicine | 1675 Lorient Ter, San Jose, CA 95133-1515 | 2016-05-27 |
| 1508240102 | Srijana Davuluri | Internal Medicine | 751 S Bascom Avenue, San Jose, CA 95128 | 2015-07-13 |
| 1679992986 | Piyanka Estelle Chandra | Internal Medicine | 275 Hospital Pkwy Ste 706, San Jose, CA 95119-1102 | 2014-04-15 |
| 1942622717 | Affordable Unique Health Care Inc | Internal Medicine | 2070 Silence Dr, San Jose, CA 95148-1918 | 2014-01-14 |
| 1700227873 | Yu-chien Cheng | Internal Medicine | 275 Hospital Pkwy Ste 600, San Jose, CA 95119 | 2013-07-17 |
| 1639499866 | Nayyar Mumtaz Masood | Internal Medicine | 4003 Claitor Way, San Jose, CA 95132-3212 | 2010-06-10 |
| 1740507367 | Sweetheart T Ador-dionisio | Internal Medicine | 280 Hospital Pkwy Bldg D, San Jose, CA 95119-1103 | 2010-04-21 |
| 1467775866 | Dinh Xuan Dam M.d. Corporation | Internal Medicine | 200 N Jackson Ave Ste C, San Jose, CA 95116-1601 | 2010-03-12 |
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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.