Individual provider Active NPI

Thaichan Jobalia, MD

  • Internal Medicine Physician
  • Los Gatos, CA
National Provider Identifier
1578526299
Registry record updated Sep 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A62153 Issued in CA
Practice address
15400 Los Gatos Blvd
Los Gatos, CA 95032-2502
Phone
(408) 523-3102
NPI assigned
Apr 12, 2006
Last updated
Sep 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A62153 CA Primary

Addresses

Primary practice location

15400 Los Gatos Blvd
Los Gatos, CA 95032-2502

Mailing address

325 Distel Cir
Los Altos, CA 94022-1408
Phone (408) 523-3102

Other identifiers 1

IdentifierTypeStateIssuer
00A621530MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090127000084 CA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 8123182714 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
University of California, Geffen School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sutter Bay Medical FoundationGroup PAC ID 4284538778, 3,783 clinicians

Practice addresses (Care Compare)

1071 Blossom Hill Rd
San Jose, CA 95123-1105
Phone (408) 445-4010

123 S San Mateo Dr
San Mateo, CA 94401-3804
Phone (650) 343-4200

15400 Los Gatos Blvd
Los Gatos, CA 95032-2502
Phone (408) 739-6000

16130 Juan Hernandez Dr
Morgan Hill, CA 95037-5527

2441 Mission College Blvd
Santa Clara, CA 95054-1214
Phone (800) 478-8837

2581 Samaritan Dr
San Jose, CA 95124-4112

301 Industrial Rd
San Carlos, CA 94070-2603
Phone (415) 600-1000

370 Distel Cir
Los Altos, CA 94022-1404
Phone (650) 254-5200

701 E El Camino Real
Mountain View, CA 94040-2833
Phone (650) 691-6174

795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A62153CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter Bay Medical Foundation Internal Medicine CurrentSince Mar 10, 2009 Accepting new patients
Sutter Bay Medical Foundation Current Accepting new patients
County of Santa Clara Internal Medicine CurrentSince Apr 25, 1997 Accepting new patients
Sutter Bay Medical Foundation CurrentSince Mar 10, 2009 Accepting new patients
County of Santa Clara Current Accepting new patients
El Camino Hospital Past Accepting new patients
County of Santa Clara Past Accepting new patients
Bass Medical Group Past Accepting new patients
Sutter East Bay Medical Foundation Internal Medicine Past Accepting new patients

Locations

20410 Town Center Ln
Ste F150
Cupertino, CA 95014
Phone (408) 523-3460

3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800

7475 Camino Arroyo
Gilroy, CA 95020
Phone (408) 852-2400

325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977

370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200

15400 Los Gatos Blvd
Los Gatos, CA 95032
Phone (408) 523-3102

16130 Juan Hernandez Dr
Ste 108
Morgan Hill, CA 95037
Phone (408) 227-6300

701 E El Camino Real
Mountain View, CA 94040
Phone (650) 404-8370

795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832

795 El Camino Real
#1112
Palo Alto, CA 94301

3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847

1993 McKee Rd
San Jose, CA 95116
Phone (408) 254-6320

750 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-2320

751 S Bascom Ave
San Jose, CA 95128
Phone (408) 885-5110

123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200

2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727

325 N Mathilda Ave
Sunnyvale, CA 94085
Phone (408) 733-4380

550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865

Interoperability endpoints

  • Direct secure messaging: thaichan.jobalia.1@14789.direct.athenahealth.com
  • Direct secure messaging: tjobalia33563@hisp.ehr.sutterhealth.org

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632096000000",
    "number": "1578526299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 DISTEL CIR",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940221408",
            "telephone_number": "408-523-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15400 LOS GATOS BLVD",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322502",
            "telephone_number": "408-523-3102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOBALIA",
        "first_name": "THAICHAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-12",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A62153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A621530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.