Evergreen Pediatrics Inc
LBN: Evergreen Pediatrics Inc
Evergreen Pediatrics Inc is an health care organization with primary practice located at 4205 San Felipe Rd #110, San Jose CA 95135-1503. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as the primary health care specialty.
Evergreen Pediatrics Inc can be contacted via phone (408) 238-8303, or through Nigam, Pronoti via phone (408) 238-8303.
Contact Information
Primary practice address
4205 San Felipe Rd #110
San Jose CA 95135-1503
Phone: (408) 238-8303
Fax: (408) 238-8375
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | A33613 | California |
Profile Details
| NPI number | 1972641736 |
|---|---|
| LBN Legal business name | Evergreen Pediatrics Inc |
| DBA Doing business as | |
| Authorized official | Nigam, Pronoti Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 2nd, 2007 |
| Last updated | Oct 2nd, 2013 - about 12 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 | 1972641736 | NPPES |
| California | MEDICAID | 00C431251 | |
| California | MEDICAID | 00A336130 | |
| California | Other | R09208 | |
| California | Other | 1053390310 | |
| California | Other | 1750497608 | |
| California | Other | R09238 |
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