Evergreen Medical Group, Inc.

Primary specialty

Rheumatology PhysicianTaxonomy code 207RR0500X

License

A100943 Issued in CA

Legal business name

EVERGREEN MEDICAL GROUP, INC.

Practice address

2690 S White Rd Ste 50
San Jose, CA 95148-2075

Phone

(408) 223-7000

Fax

(408) 223-7001

NPI assigned

May 27, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Lily Kao, M.D.

Title

Physician

Phone

(408) 223-7000

Specialties & licenses 1

Addresses

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

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

{
    "created_epoch": "1306454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330905600000",
    "number": "1508159294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 S WHITE RD STE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482075",
            "telephone_number": "408-223-7000",
            "fax_number": "408-223-7001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 S WHITE RD STE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482075",
            "telephone_number": "408-223-7000",
            "fax_number": "408-223-7001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-27",
        "last_updated": "2012-03-05",
        "status": "A",
        "authorized_official_last_name": "KAO",
        "authorized_official_first_name": "LILY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "408-223-7000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": "CA",
            "license": "A100943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Evergreen Hematology Oncology Associates
• Evergreen Hills Medical Group
• Evergreen Medical Associates Inc
• Evergreen Natural Healing Arts
• Evergreen Pediatric Associates Inc.
• Evergreen Pediatrics Inc
• Evergreen Pharmacy Inc
• Evergreen Pharmacy Inc

• Rheumatology Physician in San Jose, CA
• Providers in San Jose, CA by specialty
• Rheumatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 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.