Jack Siegel, M.D., Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

G317620 Issued in CA

Legal business name

JACK SIEGEL, M.D., INC.

Practice address

2585 Samaritan Dr Ste 303
San Jose, CA 95124-4107

Phone

(408) 358-3458

Fax

(408) 356-6191

NPI assigned

Apr 14, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Jack Siegel, M.D.

Title

President

Phone

(408) 358-3458

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1271203200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1271203200000",
    "number": "1972829018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 SAMARITAN DR STE 303",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244107",
            "telephone_number": "408-358-3458",
            "fax_number": "408-356-6191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2585 SAMARITAN DR STE 303",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951244107",
            "telephone_number": "408-358-3458",
            "fax_number": "408-356-6191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACK SIEGEL, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-14",
        "last_updated": "2010-04-14",
        "status": "A",
        "authorized_official_last_name": "SIEGEL",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "408-358-3458",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CA",
            "license": "G317620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in San Jose, CA
• Providers in San Jose, CA by specialty
• Health Service Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.