NPIMap

Organization Active NPI

Juan C Carrillo MD a Professional Corporation

Doing business as Buena Salud Pediatrics

  • Primary Care Clinic/Center
  • San Jose, CA
National Provider Identifier
1740793090
Registry record updated Nov 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
G574290 Issued in CA
Legal business name
JUAN C CARRILLO MD A PROFESSIONAL CORPORATION
Doing business as
Buena Salud Pediatrics
Practice address
2880 Story Rd FL 2
San Jose, CA 95127-3942
Phone
(408) 929-5439
Fax
(408) 929-5010
NPI assigned
Nov 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2017

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

Authorized official

Name
Juan C Carrillo, MDNPI 1124048301
Title
MD
Phone
(408) 929-5439

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X G574290 CA Primary

Addresses

Primary practice location

2880 Story Rd FL 2
San Jose, CA 95127-3942

Mailing address

2880 Story Rd FL 2
San Jose, CA 95127-3942
Phone (408) 929-5439

Other names 1

  • BUENA SALUD PEDIATRICS Doing business as

National Provider Directory

National Provider Directory

Locations

2880 Story Rd
Fl 2
San Jose, CA 95127
Phone (408) 929-5439

Practitioners & affiliated clinicians

Practitioners 3

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": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1740793090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2880 STORY RD FL 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273942",
            "telephone_number": "408-929-5439",
            "fax_number": "408-929-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2880 STORY RD FL 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951273942",
            "telephone_number": "408-929-5439",
            "fax_number": "408-929-5010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUAN C CARRILLO MD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "CARRILLO",
        "authorized_official_first_name": "JUAN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "408-929-5439",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "G574290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUENA SALUD PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Nov 8, 2017; 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.