Valley Advantage Medical Group Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

VALLEY ADVANTAGE MEDICAL GROUP INC

Practice address

2365 Quimby Road
Suite 160
San Jose, CA 95122-1337

Phone

(408) 550-2750

Fax

(408) 550-2755

NPI assigned

Jan 12, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Tam Hoang Nguyen, D.O.NPI 1962520478

Title

President

Phone

(408) 258-5083

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 2

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

• Tam Hoang Nguyen, D.O.

  • Internal Medicine Physician
  • San Jose, CA
  • NPI 1962520478
  Medicare reassignment NPD Authorized official
• Rau Van Bui, MD

  • Family Medicine Physician
  • San Jose, CA
  • NPI 1891808804
  Medicare reassignment NPD

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

{
    "created_epoch": "1515715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636934400000",
    "number": "1215445291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4945 PALEMETTO DUNES CT",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951382131",
            "telephone_number": "408-258-5083",
            "fax_number": "408-258-4347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2365 QUIMBY ROAD",
            "address_2": "SUITE 160",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951221337",
            "telephone_number": "408-550-2750",
            "fax_number": "408-550-2755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY ADVANTAGE MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-12",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "TAM",
        "authorized_official_middle_name": "HOANG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-258-5083",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yazmin Lizbeth Vallejo-Gonzalez
• Venus Vallejo
• Yadira Vallejo
• Jenelle Valles
• Valley Acupuncture
• Valley Ambulatory Surgery Center
• Valley Cardiovascular Associates Inc
• Valley Care Pharmacy LLC
• Valley Medical Center
• Valley Medical Consultants, Inc.

• Internal Medicine Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.