South Bay Sports and Family Medicine, a Medical Corporation

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

SOUTH BAY SPORTS AND FAMILY MEDICINE, A MEDICAL CORPORATION

Doing business as

Sbsfm

Practice address

221 E Hacienda Ave
Suite B
Campbell, CA 95008-6616

Phone

(408) 376-3350

Fax

(408) 374-4130

NPI assigned

Jul 31, 2007

Organization subpart

No

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

Authorized official

Name

Christian James Fulmer, DO

Title

Ceo

Phone

(408) 568-2641

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• SBSFM Doing business as

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

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219190400000",
    "number": "1881884310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 E HACIENDA AVE",
            "address_2": "SUITE B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086616",
            "telephone_number": "408-376-3350",
            "fax_number": "408-374-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 E HACIENDA AVE",
            "address_2": "SUITE B",
            "city": "CAMPBELL",
            "state": "CA",
            "postal_code": "950086616",
            "telephone_number": "408-376-3350",
            "fax_number": "408-374-4130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BAY SPORTS AND FAMILY MEDICINE, A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2008-08-20",
        "status": "A",
        "authorized_official_last_name": "FULMER",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-568-2641",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ06553Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SBSFM",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maribel Soto
• Vanessa Jacqueline Soto
• South Bay Angiography and Interventional Center
• South Bay Pathology Medical Associates
• South Bay Senior Solutions Inc. (Home Instead Senior Care)
• Southbay Oncology Hematology Partners Medical Associates
• Nanae Spade
• Speak Easy Learning Center, Speech Therapists Inc
• Spectrum Cultural Institute Inc
• Inna Spier, MD

• Primary Care Clinic/Center in Campbell, CA
• Providers in Campbell, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.