NPIMap

Organization Active NPI

South Bay Bariatrics Medical Corporation PC

  • Surgery Physician
  • San Jose, CA
National Provider Identifier
1760710396
Registry record updated Feb 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C51274 Issued in CA
Legal business name
SOUTH BAY BARIATRICS MEDICAL CORPORATION PC
Practice address
2505 Samaritan Dr
Suite 600
San Jose, CA 95124-4006
Phone
(408) 402-9911
Fax
(408) 402-9901
NPI assigned
Nov 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2010

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

Authorized official

Name
Robert V McKeen Jr., M.D.
Title
Owner
Phone
(408) 402-9911

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X C51274 CA Primary

Addresses

Primary practice location

2505 Samaritan Dr
Suite 600
San Jose, CA 95124-4006

Mailing address

2505 Samaritan Dr
Suite 600
San Jose, CA 95124-4006
Phone (408) 402-9911

National Provider Directory

National Provider Directory

Locations

14981 National Ave
Ste 4
Los Gatos, CA 95032
Phone (408) 358-4747

Practitioners & affiliated clinicians

Practitioners 4

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": "1258588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265587200000",
    "number": "1760710396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2505 SAMARITAN DR",
            "address_2": "SUITE 600",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244006",
            "telephone_number": "408-402-9911",
            "fax_number": "408-402-9901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2505 SAMARITAN DR",
            "address_2": "SUITE 600",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244006",
            "telephone_number": "408-402-9911",
            "fax_number": "408-402-9901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY BARIATRICS MEDICAL CORPORATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-19",
        "last_updated": "2010-02-08",
        "status": "A",
        "authorized_official_last_name": "MCKEEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "408-402-9911",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CA",
            "license": "C51274",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Feb 8, 2010; 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.