NPIMap

Organization Active NPI

Northern California Kidney Stone Center Inc

  • Ambulatory Surgical Clinic/Center
  • Las Gatos, CA
National Provider Identifier
1710085154
Registry record updated Jul 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
NORTHERN CALIFORNIA KIDNEY STONE CENTER INC
Practice address
16400 Lark Ave
Ste 100
Las Gatos, CA 95032
Phone
(408) 358-2805
Fax
(408) 358-2810
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2008

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

Authorized official

Name
Alli Moayed, MD
Title
President
Phone
(408) 358-2805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

16400 Lark Ave
Ste 100
Las Gatos, CA 95032

Mailing address

16400 Lark Ave
Ste 100
Las Gatos, CA 95032
Phone (408) 358-2805

National Provider Directory

National Provider Directory
Tax ID family
Northern California Kidney Stone 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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215734400000",
    "number": "1710085154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 LARK AVE",
            "address_2": "STE 100",
            "city": "LAS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-358-2805",
            "fax_number": "408-358-2810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 LARK AVE",
            "address_2": "STE 100",
            "city": "LAS GATOS",
            "state": "CA",
            "postal_code": "95032",
            "telephone_number": "408-358-2805",
            "fax_number": "408-358-2810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN CALIFORNIA KIDNEY STONE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-07-11",
        "status": "A",
        "authorized_official_last_name": "MOAYED",
        "authorized_official_first_name": "ALLI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-358-2805",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2008; 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.