Individual provider Active NPI

Jeffrey C Juanlu, D.O.

  • Hospitalist Physician
  • Los Gatos, CA
National Provider Identifier
1922286418
Registry record updated Nov 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
20A9758 Issued in CA
Practice address
355 Dardanelli LN
Los Gatos, CA 95032-1438
Phone
(408) 866-4036
Fax
(408) 871-7491
NPI assigned
Feb 6, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 20A9758 CA Primary

Addresses

Primary practice location

355 Dardanelli LN
Los Gatos, CA 95032-1438

Mailing address

86 Paterson PL
Santa Clara, CA 95050-6759
Phone (408) 645-5547

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080505000301 CA Practitioner - Internal Medicine 7416036355 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A9758CAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Juanlu Medical Corporation CurrentSince Jun 1, 2011 Accepting new patients
John Muir Trauma Physicians Billing Service CurrentSince Jan 27, 2010 Accepting new patients
John Muir Trauma Physicians Billing Service Hospitalist Current Accepting new patients

Locations

2540 East St
Concord, CA 94520
Phone (925) 674-2228

1601 Ygnacio Valley Rd
Walnut Creek, CA 94598
Phone (925) 295-1545

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1202256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415923200000",
    "number": "1922286418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 PATERSON PL",
            "city": "SANTA CLARA",
            "state": "CA",
            "postal_code": "950506759",
            "telephone_number": "408-645-5547",
            "fax_number": "925-820-7996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 DARDANELLI LN",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321438",
            "telephone_number": "408-866-4036",
            "fax_number": "408-871-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUANLU",
        "first_name": "JEFFREY",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-06",
        "last_updated": "2014-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "20A9758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Gatos, CA

Sources for this page

Verify at the official NPI Registry.