Arun Villivalam, MD Inc

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

73520 Issued in CA

Legal business name

ARUN VILLIVALAM, MD INC

Doing business as

Los Gatos Doc, Inc.

Practice address

15195 National Ave
Suite 205
Los Gatos, CA 95032-2631

Phone

(408) 502-6040

Fax

(408) 502-6041

NPI assigned

Apr 28, 2016

Last updated

Jun 15, 2016By 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. Arun Villivalam, MDNPI 1639355944

Title

President

Phone

(408) 502-6040

Specialties & licenses 1

Addresses

Other names 1

• Los Gatos Doc, Inc. Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13128/brand/1/csg/1/fhir/r4

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.

• Arun Villivalam, M.D,

  • Family Medicine Physician
  • Los Gatos, CA
  • NPI 1639355944
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465948800000",
    "number": "1245685130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15195 NATIONAL AVE",
            "address_2": "SUITE 205",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322631",
            "telephone_number": "408-502-6040",
            "fax_number": "408-502-6041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15195 NATIONAL AVE",
            "address_2": "SUITE 205",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322631",
            "telephone_number": "408-502-6040",
            "fax_number": "408-502-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARUN VILLIVALAM, MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-28",
        "last_updated": "2016-06-15",
        "status": "A",
        "authorized_official_last_name": "VILLIVALAM",
        "authorized_official_first_name": "ARUN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-502-6040",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "73520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Los Gatos Doc, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Primary Care Clinic/Center in Los Gatos, CA
• Providers in Los Gatos, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; 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.