Organization Active NPI

Rodolfo a Morales M D a Professional Corporation

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Campbell, CA
National Provider Identifier
1124326830
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
C38251 Issued in CA
Legal business name
RODOLFO A MORALES M D A PROFESSIONAL CORPORATION
Practice address
3803 S Bascom Ave
Suite 102B
Campbell, CA 95008-7317
Phone
(408) 559-1011
Fax
(408) 559-1191
NPI assigned
Mar 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Authorized official

Name
Rodolfo Antonia Morales, M. D.NPI 1831135656
Title
Owner
Phone
(408) 559-1011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208G00000X C38251 CA Primary

Addresses

Primary practice location

3803 S Bascom Ave
Suite 102B
Campbell, CA 95008-7317

Mailing address

3803 S Bascom Ave
Suite 102B
Campbell, CA 95008-7317
Phone (408) 559-1011

Other identifiers 4

IdentifierTypeStateIssuer
HC382510OtherCAHMO
EC382570OtherCACHAMPUS
00C382510MedicaidCA
PC382510OtherCAPPO

National Provider Directory

National Provider Directory

Locations

3803 S Bascom Ave
#102B
Campbell, CA 95008
Phone (408) 559-1011

3803 S Bascom Ave
Ste 102B
Campbell, CA 95008
Phone (408) 559-1011

15405 Los Gatos Blvd
Ste 202
Los Gatos, CA 95032
Phone (408) 356-8390

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1299110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299110400000",
    "number": "1124326830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 S BASCOM AVE",
            "address_2": "SUITE 102B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087317",
            "telephone_number": "408-559-1011",
            "fax_number": "408-559-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3803 S BASCOM AVE",
            "address_2": "SUITE 102B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087317",
            "telephone_number": "408-559-1011",
            "fax_number": "408-559-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RODOLFO A MORALES M D A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-03",
        "last_updated": "2011-03-03",
        "status": "A",
        "authorized_official_last_name": "MORALES",
        "authorized_official_first_name": "RODOLFO",
        "authorized_official_middle_name": "ANTONIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-559-1011",
        "authorized_official_credential": "M. D."
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "CA",
            "license": "C38251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HMO",
            "identifier": "HC382510",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHAMPUS",
            "identifier": "EC382570",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00C382510",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPO",
            "identifier": "PC382510",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbell, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2011; 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.