NPIMap

Organization Active NPI

North East Medical Services

  • Federally Qualified Health Center (FQHC)
  • San Jose, CA
National Provider Identifier
1083035505
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
NORTH EAST MEDICAL SERVICES
Practice address
1870 Lundy Ave
San Jose, CA 95131-1826
Phone
(408) 573-9686
Fax
(408) 573-9685
NPI assigned
Dec 31, 2013
Last updated
Dec 31, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTH EAST MEDICAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Authorized official

Name
Mr. Eddie W. Chan, PHARM.D.
Title
President & Ceo
Phone
(415) 391-9686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X CA Primary

Addresses

Primary practice location

1870 Lundy Ave
San Jose, CA 95131-1826

Mailing address

1520 Stockton St
San Francisco, CA 94133-3354
Phone (415) 391-9686

Other names 1

  • NORTH EAST MEDICAL SERVICES - 1870 LUNDY Other name

National Provider Directory

National Provider Directory
Tax ID family
North East Medical57 organizations share this tax ID, including this one
Part of
North East Medical

Organizations with this tax ID in the same state 17

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1388448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388448000000",
    "number": "1083035505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1520 STOCKTON ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941333354",
            "telephone_number": "415-391-9686",
            "fax_number": "415-433-4726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1870 LUNDY AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311826",
            "telephone_number": "408-573-9686",
            "fax_number": "408-573-9685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH EAST MEDICAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTH EAST MEDICAL SERVICES",
        "enumeration_date": "2013-12-31",
        "last_updated": "2013-12-31",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "415-391-9686",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NORTH EAST MEDICAL SERVICES - 1870 LUNDY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Dec 31, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.