Active NPI
Galen Inpatient Physicians, PC
- Internal Medicine Physician
- San Jose, CA
National Provider Identifier
1063456283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- GALEN INPATIENT PHYSICIANS, PC
- Practice address
- 225 N Jackson Ave
San Jose, CA 95116-1603 - Phone
- (408) 378-6131
- NPI assigned
- Jun 16, 2006
- Last updated
- Mar 16, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Theophile Koury, PRESIDENT
- Title
- M.D
- Phone
- (510) 350-2644
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
225 N Jackson Ave
San Jose, CA 95116-1603
Mailing address
2100 Powell St Ste 400
Emeryville, CA 94608-1826
Phone (510) 350-2644
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GR0093523 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, OR
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040322000680 | CA | Part B Supplier - Clinic/Group Practice | 3678464633 |
Receives reassigned benefits from 977 practitioners This NPI is an additional NPI on the enrollment Practice locations: Oxnard, CA; Redding, CA; Roseville, CA; Saint Helena, CA; San Luis Obispo, CA; Selma, CA; Simi Valley, CA; Sonora, CA… |
| O20140702002722 | OR | Part B Supplier - Clinic/Group Practice | 3678464633 |
Receives reassigned benefits from 47 practitioners 6 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Portland, OR; Roseburg, OR; Tillamook, OR |
Other NPIs on the same Medicare enrollment 6
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Internal Medicine Physician
- Antioch, CA
- NPI 1083658223
O20140702002722
-
dba Vituity
- Internal Medicine Physician
- Madera, CA
- NPI 1063752939
O20140702002722
-
dba Vituity
- Internal Medicine Physician
- Hanford, CA
- NPI 1114285657
O20140702002722
-
dba Vituity
- Internal Medicine Physician
- Roseburg, OR
- NPI 1063833960
O20140702002722
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1615852800000",
"number": "1063456283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2100 POWELL ST STE 400",
"city": "EMERYVILLE",
"state": "CA",
"postal_code": "946081826",
"telephone_number": "510-350-2644"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 N JACKSON AVE",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951161603",
"telephone_number": "408-378-6131"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GALEN INPATIENT PHYSICIANS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-16",
"last_updated": "2021-03-16",
"certification_date": "2021-03-16",
"status": "A",
"authorized_official_last_name": "KOURY",
"authorized_official_first_name": "THEOPHILE",
"authorized_official_title_or_position": "M.D",
"authorized_official_telephone_number": "510-350-2644",
"authorized_official_credential": "PRESIDENT"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "GR0093523",
"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 Mar 16, 2021; 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.