South Bay Medical Center, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

SOUTH BAY MEDICAL CENTER, INC.

Practice address

16400 Lark Ave Ste 100
Los Gatos, CA 95032-2563

Phone

(408) 384-9719

NPI assigned

Feb 28, 2020

Last updated

Feb 28, 2020By 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

Ali Moayed

Title

Facility Administrator

Phone

(408) 515-4699

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Los Gatos Drug and Alcohol Recovery Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• South Bay Medical Center, Inc.

  dba Los Gatos Drug and Alcohol Recovery Center

  • Substance Abuse Rehabilitation Facility
  • Monte Sereno, CA
  • NPI 1629604657
  NPD tax ID

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.

• Farzaneh Tabrizi, MD

  • Family Medicine Physician
  • Los Gatos, CA
  • NPI 1194826909
  Medicare reassignment NPD

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

{
    "created_epoch": "1582848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582848000000",
    "number": "1487288437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 LARK AVE STE 100",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 LARK AVE STE 100",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322563",
            "telephone_number": "408-384-9719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY MEDICAL CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-28",
        "last_updated": "2020-02-28",
        "certification_date": "2020-02-28",
        "status": "A",
        "authorized_official_last_name": "MOAYED",
        "authorized_official_first_name": "ALI",
        "authorized_official_title_or_position": "FACILITY ADMINISTRATOR",
        "authorized_official_telephone_number": "408-515-4699"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raquel M Sotoavalos
• South Bascom Pediatrics Inc
• South Bay Joint Care Inc
• South Bay Medical Associates, Inc
• South Bay Medical Center Inc (Los Gatos Drug and Alcohol Recovery Center)
• South Bay Surgery Center, Inc.
• Spark Psychology, Inc.
• Special Dental Hygiene Care, Inc.
• Specialized Surgeons, Inc.
• Spectrum Eye Physicians, a Medical Corporation (Spectrum Eye Physicians)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2020; 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.