MR. SHASHANK JOLLY (NPI# 1902047814) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902047814 |
| Entity Type | Individual |
| Full Name | MR. SHASHANK JOLLY |
| Credential | M.D |
| Practice Address |
2333 Mowry Ave Ste 300 Fremont CA 94538-1626 |
| Mailing Address |
46689 Windmill Dr Fremont CA 94539-7238 |
| Practice Telephone | 6507669338 |
| Practice Fax Number | 4085169377 |
| Mailing Telephone | 4083898774 |
| Mailing Fax Number | 4085169377 |
| Enumeration Date | 2009-03-23 |
| Last Update Date | 2019-04-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | A126261 | CA | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11204 | ND | Allopathic & Osteopathic Physicians |
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | MD430577 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1902047814 | 05 | |
| CA | STATE LICENSE | A126261 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 39141 Civic Center Drive #335, Fremont, CA 94538 | 5102481409 | 5107970301 |
| Street Address |
2333 MOWRY AVE STE 300 |
| City | FREMONT |
| State | CA |
| Zip Code | 94538-1626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457839581 | Aye Aung | Nurse Practitioner | 2333 Mowry Ave Ste 300, Fremont, CA 94538-1626 | 2018-07-31 |
| 1023464336 | Jay Shah | Family Medicine | 2333 Mowry Ave Ste 300, Fremont, CA 94538-1626 | 2016-05-05 |
| 1730558479 | We Care Hospice Inc | Hospice Care, Community Based | 2333 Mowry Ave Ste 300, Fremont, CA 94538-1626 | 2015-09-23 |
| 1629380464 | Jaisri Tomara Maharaj | Internal Medicine | 2333 Mowry Ave Ste 300, Fremont, CA 94538-1626 | 2010-07-09 |
| 1558698829 | Victor Jose Arevalo Meceda | Family Medicine | 2333 Mowry Ave Ste 300, Fremont, CA 94538-1626 | 2009-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699394460 | Bay Area Kidney Care Medical Group Inc. | Clinic/Center | 39370 Mozart Terrace Unit 106, Fremont, CA 94538 | 2020-04-13 |
| 1740847284 | Gloria Ann Federico | Behavior Technician | 39210 State St., Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2019-05-21 |
| 1093270688 | Timothy Lorne Haynes | Chiropractor | 3775 Beacon Ave., Suite 200, Fremont, CA 94538 | 2019-02-07 |
| 1902370067 | Nicole Sandoval | Counselor | 39155 Liberty St Suite E500, Fremont, CA 94538 | 2019-01-11 |
| 1497225015 | Megan Galban | Behavior Technician | 39210 State St. Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1780154302 | Karla Patricia Plascencia | Behavior Technician | 39210 State Street Suite 220, Fremont, CA 94538 | 2018-11-27 |
| 1215407846 | Sydney J Torrens | Behavior Technician | 39210 State St. Suite 220 Fremont, Ca 94538, Fremont, CA 94538 | 2018-11-27 |
| 1932676277 | Jarah Harvan | Psychologist | 1999 Mowry Ave Ste F, Fremont, CA 94538 | 2018-10-24 |
| 1205321965 | Chien Shien Yang Md Inc | Psychiatry & Neurology | 1860 Mowry Ave Ste 301a, Fremont, CA 94538 | 2018-06-26 |
| 1912416199 | Advanced Interventional Surgical Center | Clinic/Center | 3077 Stevenson Blvd, Fremont, CA 94538 | 2017-09-20 |
| Find all providers in zip 94538 | ||||
| Taxonomy Code | 208G00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Thoracic Surgery, 2007. http://www.abts.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Thoracic Surgery. Thoracic surgeons have the knowledge, experience and technical skills to accurately diagnose, operate upon safely, and effectively manage patients with thoracic diseases of the chest. This requires substantial knowledge of cardiorespiratory physiology and oncology, as well as capability in the use of heart assist devices, management of abnormal heart rhythms and drainage of the chest cavity, respiratory support systems, endoscopy and invasive and noninvasive diagnostic techniques. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194800862 | Richard S. Godfrey | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 39400 Paseo Padre Pkwy, Fremont, CA 94538-2310 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598370728 | North County Cvt Surgery Associates | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 3156 Vista Way Ste 100, Oceanside, CA 92056-3694 | 2020-09-14 |
| 1417560756 | Valiana Vascular Institute Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 2501 E Chapman Ave Ste 220, Fullerton, CA 92831-3108 | 2020-08-26 |
| 1891252474 | Miguel Puig Md A Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1430 Esplanade Ste 10, Chico, CA 95926-3366 | 2019-03-01 |
| 1598247991 | Pavel V Petrik Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1331 W Avenue J Ste 203, Lancaster, CA 93534-2954 | 2018-08-31 |
| 1942797378 | Sharon A Bogerty Md Inc | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 105 N Bascom Ave Ste 101b, San Jose, CA 95128-1811 | 2018-04-20 |
| 1992231112 | Samer Kanaan Md A Professional Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 27451 Los Altos, Suite 290, Mission Viejo, CA 92691 | 2017-05-08 |
| 1073065512 | Central California Chest Surgery | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 729 N Medical Center Dr W Ste 223, Clovis, CA 93611-6885 | 2016-11-01 |
| 1407214612 | George Arnold Mulder | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 1150 Laurel St, Pasadena, CA 91103-2329 | 2016-02-02 |
| 1760849905 | Steven R Gundry Md Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 555 E Tachevah Dr Ste 3w103, Palm Springs, CA 92262-5747 | 2016-01-19 |
| 1386018687 | Riyad Youssef Tarazi | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 9120 Judicial Dr, Apt 7522, San Diego, CA 92122-6700 | 2015-11-24 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on MR. SHASHANK JOLLY.
| 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.