Organization Active NPI

Michael C Kushlan MD Inc

  • Gastroenterology Physician
  • San Jose, CA
National Provider Identifier
1376859231
Registry record updated Jun 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MICHAEL C KUSHLAN MD INC
Practice address
2512 Samaritan CT Ste G
San Jose, CA 95124-4002
Phone
(408) 356-0468
Fax
(408) 356-4821
NPI assigned
Aug 29, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2012

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

Authorized official

Name
Mr. Michael Charles Kushlan, M.D.
Title
President
Phone
(408) 356-0468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

2512 Samaritan CT Ste G
San Jose, CA 95124-4002

Mailing address

2512 Samaritan CT Ste G
San Jose, CA 95124-4002
Phone (408) 356-0468

National Provider Directory

National Provider Directory

Locations

2505 Samaritan Dr
Ste 502
San Jose, CA 95124
Phone (408) 356-0468

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": "1283040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340409600000",
    "number": "1376859231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2512 SAMARITAN CT STE G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244002",
            "telephone_number": "408-356-0468",
            "fax_number": "408-356-4821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2512 SAMARITAN CT STE G",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244002",
            "telephone_number": "408-356-0468",
            "fax_number": "408-356-4821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL C KUSHLAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-29",
        "last_updated": "2012-06-23",
        "status": "A",
        "authorized_official_last_name": "KUSHLAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-356-0468",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "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 Jun 23, 2012; 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.