| South Valley Multi Specialty Medical Group Inc | |
|
173 N Morrison Ave Suite C San Jose CA 95126-2712 | |
| (408) 293-1992 | |
| (408) 293-6030 |
| Full Name | South Valley Multi Specialty Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 173 N Morrison Ave, San Jose, California |
| Authorized Official Name and Position | Costantino T Gallo (PRESIDENT, CEO) |
| Authorized Official Contact | 4082931992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Valley Multi Specialty Medical Group Inc 173 N Morrison Ave Suite C San Jose CA 95126-2712 Ph: (408) 293-1992 | South Valley Multi Specialty Medical Group Inc 173 N Morrison Ave Suite C San Jose CA 95126-2712 Ph: (408) 293-1992 |
| NPI Number | 1215991583 |
|---|---|
| Provider Enumeration Date | 04/13/2006 |
| Last Update Date | 12/06/2012 |
| Medicare PECOS PAC ID | 9234117813 |
|---|---|
| Medicare Enrollment ID | O20040709001211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215991583 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Primary |
| Provider Name | Costantino T Gallo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669402384 PECOS PAC ID: 9133107717 Enrollment ID: I20080523000451 |
| Provider Name | Norman S Lowenbraun |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962448530 PECOS PAC ID: 9436229234 Enrollment ID: I20080605000710 |
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Shen Medicine & Pediatrics Assc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 Rosewood Ave, San Jose, CA 95117 Phone: 408-296-9800 Fax: 408-296-9805 | |
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