San Jose Health Clinic, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

25569 Issued in AZ

Legal business name

SAN JOSE HEALTH CLINIC, LLC

Practice address

1962 E Juan Sanchez Blvd
Ste 1
San Luis, AZ 85349

Phone

(928) 722-6098

Fax

(928) 627-0007

NPI assigned

Mar 3, 2008

Last updated

Mar 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jose M Piscoya, M.D.

Title

President

Phone

(928) 722-6098

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204502400000",
    "number": "1770753162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1689",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "853491689",
            "telephone_number": "928-722-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1962 E JUAN SANCHEZ BLVD",
            "address_2": "STE 1",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "85349",
            "telephone_number": "928-722-6098",
            "fax_number": "928-627-0007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JOSE HEALTH CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2008-03-03",
        "status": "A",
        "authorized_official_last_name": "PISCOYA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-722-6098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "25569",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "838352",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Priscilla Rodriguez Legaspi
• Leonardo Rodriguez, M.D.
• Ava Rose, M.D.
• Todd K Runyan, M.D.
• Manuel Angel Salcido, D.D.S.
• San Jose Integrated Clinic LLC
• San Luis Walk-in Clinic, Inc. (San Luis Urgent Care)
• San Luis Walk-in Clinic, Inc.
• San Luis Walk-in Clinic, Inc. (San Luis Outpatient Surgery Center)
• San Luis Walk-in Clinic, Inc. (San Luis Urgent Care)

• Family Medicine Physician in San Luis, AZ
• Providers in San Luis, AZ by specialty
• Family Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.