Active NPI
South Bay Medical Clinic of San Jose
- Internal Medicine Physician
- San Jose, CA
National Provider Identifier
1205320868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- SOUTH BAY MEDICAL CLINIC OF SAN JOSE
- Practice address
- 200 Jose Figueres Ave Ste 260
San Jose, CA 95116-1555 - Phone
- (408) 251-0835
- Fax
- (408) 770-3314
- NPI assigned
- Jun 18, 2018
- Last updated
- Sep 6, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Tri Minh DO, MD
- Title
- Medical Director
- Phone
- (408) 835-9601
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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | A53379 | CA | |
| Internal Medicine Physician | 207R00000X | Primary | ||
| Therapeutic Radiology Physician | 2085R0203X |
Addresses
Primary practice location
200 Jose Figueres Ave Ste 260
San Jose, CA 95116-1555
Mailing address
5091 Mitty Way Bay Medical
San Jose, CA 95129-1849
Phone (408) 835-9601
Other practice location 1
8833 Monterey Rd Ste H
Gilroy, CA 95020-7200
Phone (408) 842-1544
Other practice location 2
1625 Tully Rd Ste A
San Jose, CA 95122
Phone (408) 929-0606
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A55472 | Medicaid | CA | |
| 1619930260 | Other | CA | NPI |
| H44307 | Other | UPIN |
Other names 1
- South Bay Medical Clinic of San Jose
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1529280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1693958400000",
"number": "1205320868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5091 MITTY WAY BAY MEDICAL",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951291849",
"telephone_number": "408-835-9601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 JOSE FIGUERES AVE STE 260",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951161555",
"telephone_number": "408-251-0835",
"fax_number": "408-770-3314"
}
],
"practiceLocations": [
{
"address_1": "8833 Monterey Rd Ste H",
"address_purpose": "LOCATION",
"city": "Gilroy",
"state": "CA",
"postal_code": "950207200",
"country_code": "US",
"telephone_number": "408-842-1544",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1625 Tully Rd Ste A",
"address_purpose": "LOCATION",
"city": "San Jose",
"state": "CA",
"postal_code": "95122",
"country_code": "US",
"telephone_number": "408-929-0606",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "SOUTH BAY MEDICAL CLINIC OF SAN JOSE",
"organizational_subpart": "NO",
"enumeration_date": "2018-06-18",
"last_updated": "2023-09-06",
"certification_date": "2020-08-30",
"status": "A",
"authorized_official_last_name": "DO",
"authorized_official_first_name": "TRI",
"authorized_official_middle_name": "MINH",
"authorized_official_title_or_position": "MEDICAL DIRECTOR",
"authorized_official_telephone_number": "408-835-9601",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "CA",
"license": "A53379",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "2085R0203X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Radiology, Therapeutic Radiology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "A55472",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1619930260",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UPIN",
"identifier": "H44307",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "South Bay Medical Clinic of San Jose",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "South Bay Medical Clinic of San Jose",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "South Bay Medical Clinic of San Jose",
"code": "4",
"type": "Former Legal Business Name"
}
]
}Other providers in San Jose, CA
- South Bay Endoscopy Center a Medical Corporation
- South Bay Gi Inc
- South Bay Home Health Care, LLC
- South Bay House-Call Doctor
- South Bay Housecall Doctor Inc
- South Bay Nephrology Associates, PC
- South Bay Ophthalmology Inc
- South Bay Orthopedic and Sports Medicine Clinic, Inc.
- South Bay Paediatrics
- South Bay Pediatrics
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.