Organization Active NPI

Bay Area Hospital Physician

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1043476393
Registry record updated Jun 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
20A9636 Issued in CA
Legal business name
BAY AREA HOSPITAL PHYSICIAN
Practice address
200 Jose Figueres Ave Ste 180
San Jose, CA 95116
Phone
(408) 258-5083
Fax
(408) 258-4347
NPI assigned
Aug 5, 2008
Last updated
Jun 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Tam Hoang NguyenNPI 1962520478
Title
President/Ceo
Phone
(408) 258-5083

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 20A9636 CA Primary

Addresses

Primary practice location

200 Jose Figueres Ave Ste 180
San Jose, CA 95116

Mailing address

4945 Palemetto Dunes CT
San Jose, CA 95138-2131
Phone (408) 772-7970

Other practice location 1

920 Sunnyslope Rd
Hollister, CA 95023-5784
Phone (408) 258-5083

Other practice location 2

18181 Butterfield Blvd Ste 180
Morgan Hill, CA 95037-8112
Phone (408) 258-5083

Other identifiers 1

IdentifierTypeStateIssuer
20A9636OtherCALICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081013000248 CA Part B Supplier - Clinic/Group Practice 1456429828 Receives reassigned benefits from 6 practitioners
Practice locations: Hollister, CA; Morgan Hill, CA; San Jose, CA

National Provider Directory

National Provider Directory

Locations

10430 S De Anza Blvd
#230B
Cupertino, CA 95014
Phone (408) 258-5083

8833 Monterey Rd
Gilroy, CA 95020
Phone (408) 842-1544

200 Jose Figueres Ave
#18
San Jose, CA 95116

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1217894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1528156800000",
    "number": "1043476393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4945 PALEMETTO DUNES CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382131",
            "telephone_number": "408-772-7970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE STE 180",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95116",
            "telephone_number": "408-258-5083",
            "fax_number": "408-258-4347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Sunnyslope Rd",
            "address_purpose": "LOCATION",
            "city": "Hollister",
            "state": "CA",
            "postal_code": "950235784",
            "country_code": "US",
            "telephone_number": "408-258-5083",
            "fax_number": "408-258-4347",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18181 Butterfield Blvd Ste 180",
            "address_purpose": "LOCATION",
            "city": "Morgan Hill",
            "state": "CA",
            "postal_code": "950378112",
            "country_code": "US",
            "telephone_number": "408-258-5083",
            "fax_number": "408-258-4347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BAY AREA HOSPITAL PHYSICIAN",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-05",
        "last_updated": "2018-06-05",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TAM",
        "authorized_official_middle_name": "HOANG",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "408-258-5083"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "20A9636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "20A9636",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.