Active NPI
Lourdes Santos-Reyes, MD
- Internal Medicine Physician
- San Jose, CA
National Provider Identifier
1093299364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- A52916
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| A52916 | CA | MD | Internal 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.