Evergreen Hills Medical Group
LBN: Evergreen Hills Medical Group
Evergreen Hills Medical Group is an health care organization with primary practice located at 2690 S White Rd Suite 200, San Jose CA 95148-2076. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty.
Evergreen Hills Medical Group can be contacted via phone (408) 223-7771, or through Siao, Donald via phone (408) 223-7771.
Contact Information
Primary practice address
2690 S White Rd Suite 200
San Jose CA 95148-2076
Phone: (408) 223-7771
Fax: (408) 223-7779
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X |
Profile Details
| NPI number | 1396949822 |
|---|---|
| LBN Legal business name | Evergreen Hills Medical Group |
| DBA Doing business as | |
| Authorized official | Siao, Donald Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jun 11th, 2007 |
| Last updated | Aug 22nd, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1396949822 | NPPES |
| California | Other | A73641 | STATE LICENSE NUMBER |
| California | Other | G69952 | STATE LICENSE NUMBER |
| California | Other | A67291 | STATE LICENSE NUMBER |
| California | Other | G73395 | STATE LICENSE NUMBER |
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