G2J Clinic Inc

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

A103558 Issued in CA

Legal business name

G2J CLINIC INC

Practice address

5150 Graves Ave
Suite 11B
San Jose, CA 95129-5013

Phone

(408) 293-0800

NPI assigned

Dec 18, 2015

Last updated

Dec 18, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mi Ran Park, M.D.NPI 1992929616

Title

Medical Director

Phone

(408) 293-0800

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mi Ran Park, M.D.

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1992929616
  NPD (past) Authorized official

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

{
    "created_epoch": "1450396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450396800000",
    "number": "1194180018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5150 GRAVES AVE",
            "address_2": "SUITE 11B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951295013",
            "telephone_number": "408-293-0800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5150 GRAVES AVE",
            "address_2": "SUITE 11B",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951295013",
            "telephone_number": "408-293-0800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "G2J CLINIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-18",
        "last_updated": "2015-12-18",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "MI RAN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "408-293-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "CA",
            "license": "A103558",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Frederick F. Gabali, MD
• Jeremy Gabato
• Emmalie Gabel Salvador
• Briggette Nabil Mansour Gabriel
• Rodriguez Joana Gabriel

• Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2015; 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.