Individual provider Active NPI

Lourdes Santos-Reyes, MD

  • Internal Medicine Physician
  • San Jose, CA
National Provider Identifier
1093299364
Registry record updated Sep 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A52916 Issued in CA
Practice address
1625 Tully Rd Ste a
San Jose, CA 95122-2541
Phone
(408) 929-0606
Fax
(408) 929-1115
NPI assigned
Sep 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A52916 CA Primary

Addresses

Primary practice location

1625 Tully Rd Ste a
San Jose, CA 95122-2541

Mailing address

1625 Tully Rd Ste a
San Jose, CA 95122-2541
Phone (408) 929-0606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A52916CAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1537488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537488000000",
    "number": "1093299364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 TULLY RD STE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222541",
            "telephone_number": "408-929-0606",
            "fax_number": "408-929-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 TULLY RD STE A",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951222541",
            "telephone_number": "408-929-0606",
            "fax_number": "408-929-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANTOS-REYES",
        "first_name": "LOURDES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-21",
        "last_updated": "2018-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A52916",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 21, 2018; 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.