Organization Name: | SOUTH BAY CARDIOVASCULAR MEDICALL GROUP, INC |
NPI Number: | 1003148073 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MOHAMMAD SHENASA (OWNER) |
Mailing Address: | 105 N Bascom Ave Suite 204 San Jose |
State: | CA US |
Postal Code: | 951281811 |
Phone Number: | 4089180400 |
Fax Number: | 4082862922 |
NPI Enumeration Date: | 02/02/2010 |
NPI Last Update Date: | 10/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A50310 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |