NPIMap

Organization Active NPI

South Bay Sports and Preventive Medicine Associates, Inc.

  • Non-Pharmacy Dispensing Site
  • San Jose, CA
National Provider Identifier
1265661441
Registry record updated Jul 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
G84807 Issued in CA
Legal business name
SOUTH BAY SPORTS AND PREVENTIVE MEDICINE ASSOCIATES, INC.
Practice address
455 Oconnor Drive
Suite 150
San Jose, CA 95128
Phone
(408) 293-7767
Fax
(408) 294-6595
NPI assigned
Jul 8, 2009
Last updated
Jul 8, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2009

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

Authorized official

Name
Rebecca Guarmo, M.D.
Title
Owner/Secretary
Phone
(408) 293-7767

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X G84807 CA Primary

Addresses

Primary practice location

455 Oconnor Drive
Suite 150
San Jose, CA 95128

Mailing address

455 Oconnor Drive
Suite 150
San Jose, CA 95128
Phone (408) 293-7767

National Provider Directory

National Provider Directory
Tax ID family
South Bay Sports and Preventive Medicine Associates Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1247011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247011200000",
    "number": "1265661441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DRIVE",
            "address_2": "SUITE 150",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-293-7767",
            "fax_number": "408-294-6595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 OCONNOR DRIVE",
            "address_2": "SUITE 150",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95128",
            "telephone_number": "408-293-7767",
            "fax_number": "408-294-6595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY SPORTS AND PREVENTIVE MEDICINE ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-08",
        "last_updated": "2009-07-08",
        "status": "A",
        "authorized_official_last_name": "GUARMO",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_title_or_position": "OWNER/SECRETARY",
        "authorized_official_telephone_number": "408-293-7767",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "CA",
            "license": "G84807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 8, 2009; 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.