Organization Active NPI

El Camino Urology Medical Group, Inc

  • Urology Physician
  • Mountain View, CA
National Provider Identifier
1316989635
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
EL CAMINO UROLOGY MEDICAL GROUP, INC
Practice address
2490 Hospital Dr.
Ste. 210
Mountain View, CA 94040-4323
Phone
(650) 962-4662
Fax
(650) 962-4652
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Terry Grantham
Title
Office Manager
Phone
(650) 962-4662

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X Primary

Addresses

Primary practice location

2490 Hospital Dr.
Ste. 210
Mountain View, CA 94040-4323

Mailing address

2490 Hospital Dr.
Ste. 210
Mountain View, CA 94040-4323
Phone (650) 962-4662

National Provider Directory

National Provider Directory

Locations

205 South Dr
Mountain View, CA 94040
Phone (415) 961-5954

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": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316989635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2490 HOSPITAL DR.",
            "address_2": "STE. 210",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404323",
            "telephone_number": "650-962-4662",
            "fax_number": "650-962-4652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2490 HOSPITAL DR.",
            "address_2": "STE. 210",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940404323",
            "telephone_number": "650-962-4662",
            "fax_number": "650-962-4652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EL CAMINO UROLOGY MEDICAL GROUP, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GRANTHAM",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "650-962-4662",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.