South Bay Angiography and Interventional Center

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTH BAY ANGIOGRAPHY AND INTERVENTIONAL CENTER

Practice address

2255 S Bascom Ave
Suite 200
Campbell, CA 95008-7800

Phone

(408) 376-3626

Fax

(408) 871-2377

NPI assigned

Nov 21, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Polyxene G Kokinos, M.D.

Title

Ceo

Phone

(408) 376-3626

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479686400000",
    "number": "1124561303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 S BASCOM AVE",
            "address_2": "SUITE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087800",
            "telephone_number": "408-376-3626",
            "fax_number": "408-871-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 S BASCOM AVE",
            "address_2": "SUITE 200",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950087800",
            "telephone_number": "408-376-3626",
            "fax_number": "408-871-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY ANGIOGRAPHY AND INTERVENTIONAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A",
        "authorized_official_last_name": "KOKINOS",
        "authorized_official_first_name": "POLYXENE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-376-3626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sona Khinvasara, DDS, Inc.
• Marissa Song
• Melissa Sorci, PH.D.
• Maribel Soto
• Vanessa Jacqueline Soto
• South Bay Pathology Medical Associates
• South Bay Senior Solutions Inc.
• South Bay Sports and Family Medicine, a Medical Corporation
• Southbay Oncology Hematology Partners Medical Associates
• Nanae Spade

• Specialist in Campbell, CA
• Providers in Campbell, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.