Organization Active NPI

Coast Anesthesia Medical Group, Inc.

  • Anesthesiology Physician
  • San Jose, CA
National Provider Identifier
1194773473
Registry record updated Jul 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
COAST ANESTHESIA MEDICAL GROUP, INC.
Practice address
2105 Forest Ave
San Jose, CA 95128-1425
Phone
(408) 947-2500
NPI assigned
May 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2016

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

Authorized official

Name
Brandt A. Foreman, MD
Title
Group President
Phone
(408) 839-2043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X Primary

Addresses

Primary practice location

2105 Forest Ave
San Jose, CA 95128-1425

Mailing address

Dept 34776
PO Box 39000
San Francisco, CA 94139-0001
Phone (408) 839-2043

Other identifiers 1

IdentifierTypeStateIssuer
GR0098870MedicaidCA

Other names 1

  • Coast Anesthesia of Silicon Valley, Inc. Doing business as

National Provider Directory

National Provider Directory

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": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1194773473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 34776",
            "address_2": "PO BOX 39000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941390001",
            "telephone_number": "408-839-2043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 FOREST AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951281425",
            "telephone_number": "408-947-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COAST ANESTHESIA MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "FOREMAN",
        "authorized_official_first_name": "BRANDT",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "GROUP PRESIDENT",
        "authorized_official_telephone_number": "408-839-2043",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0098870",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coast Anesthesia of Silicon Valley, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 26, 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.