Kelley Park Medical Clinic, Inc

LBN: Kelley Park Medical Clinic, Inc
Kelley Park Medical Clinic, Inc is an health care organization with primary practice located at 749 Story Rd Suite 20, San Jose CA 95122-2600. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Kelley Park Medical Clinic, Inc can be contacted via phone (408) 794-2088, or through Nguyen, Peter Linh via phone (408) 794-2088.

Contact Information

Primary practice address
749 Story Rd Suite 20 San Jose CA 95122-2600
Phone: (408) 794-2088
Fax: (408) 292-2179
Website:
Map and Directions
Authorized official contact:
Name: Nguyen, Peter Linh Doctor of Osteopathy (DO)
Phone: (408) 794-2088

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X 20A7360 California

Profile Details

NPI number 1942340625
LBN Legal business name Kelley Park Medical Clinic, Inc
DBA Doing business as
Authorized official Nguyen, Peter Linh Doctor of Osteopathy (DO)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 8th, 2007
Last updated Aug 15th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942340625 NPPES
California MEDICAID 00AX73600
California Other 023997

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