San Jose Pacific Neurology CNTR Prof Cor

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A93854 Issued in CA

Legal business name

SAN JOSE PACIFIC NEUROLOGY CNTR PROF COR

Practice address

200 Jose Figueres Ave Ste 200
San Jose, CA 95116-1586

Phone

(408) 347-1600

Fax

(408) 347-0600

NPI assigned

Jan 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Raj Gupta, M.DNPI 1831126689

Title

M.D

Phone

(408) 347-1600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raj Gupta, M.D

  • Neurology Physician
  • San Jose, CA
  • NPI 1831126689
  Medicare reassignment Care Compare group Authorized official
• Prachi Dalal, NP

  • Nurse Practitioner
  • San Jose, CA
  • NPI 1134813900
  Medicare reassignment Care Compare group NPD
• Akshay Mahesh Shah, M.D.

  • Neurology Physician
  • San Jose, CA
  • NPI 1891095964
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583798400000",
    "number": "1124174297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161586",
            "telephone_number": "408-347-1600",
            "fax_number": "408-347-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 JOSE FIGUERES AVE STE 200",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951161586",
            "telephone_number": "408-347-1600",
            "fax_number": "408-347-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE PACIFIC NEUROLOGY CNTR PROF COR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "M.D",
        "authorized_official_telephone_number": "408-347-1600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A93854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• San Jose Medical Supply Co Inc
• San Jose Mothers' Milk Bank
• San Jose Mothers' Milk Bank
• San Jose Nephrology Medical Practice
• San Jose Orthopedic Associates Medical Corporation
• San Jose Physical Therapy Incorporated
• San Jose Pulmonary Associates
• San Jose Refractive, LLC
• San Jose Sports Medicine & Orthopedics
• San Jose State University Student Health Center

• Psychiatry Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.