EVERGREEN PEDIATRIC ASSOCIATES INC. (NPI# 1215960455) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215960455 |
| Entity Type | Organization |
| Organization Name | EVERGREEN PEDIATRIC ASSOCIATES INC. |
| Practice Address |
1642 E Capitol Expy San Jose CA 95121-1800 |
| Practice Telephone | 4082703374 |
| Practice Fax Number | 4082703384 |
| Mailing Telephone | 4082703374 |
| Mailing Fax Number | 4082703384 |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LINDA M. HA (SECRETARY) |
| Authorized Official Telephone | 4082703374 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | FNP32950 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0102160 | 05 |
| Street Address |
1642 E CAPITOL EXPY |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95121-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659310902 | Christopher Minh Vu | Pediatrics | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-06-05 |
| 1356739973 | My-phuc Le | Family Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2015-01-05 |
| 1881997963 | Indian Health Center of Santa Clara Valley | Clinic/Center | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2010-12-13 |
| 1659502136 | Sonya Lobana | Family Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2009-08-02 |
| 1457536518 | Parivash Moody | Nurse Practitioner | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2008-01-08 |
| 1124044458 | Sarah Aoi Gaskins | Psychiatry & Neurology | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-07-13 |
| 1588689814 | Lam Huu Do | Internal Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-07-13 |
| 1790718260 | Evergreen Medical Associates Inc | Internal Medicine | 1642 E Capitol Expy, San Jose, CA 95121-1800 | 2006-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922669597 | Tracy Filler, Dmd, Inc. | Dentist | 1569 Lexann Drive, Suite 202, San Jose, CA 95121 | 2019-06-25 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1538681325 | Sujata S Gawande | Dentist | 2060 Aborn Rd Ste 125, San Jose, CA 95121 | 2017-07-12 |
| 1871950188 | Keiana Harrington | Behavioral Analyst | 6958 Del Rio Dr., San Jose, CA 95121 | 2016-01-19 |
| 1679812556 | Hien Van Nguyen | Pediatrics | 1675 Burdette Dr, Ste #20, San Jose, CA 95121 | 2013-02-12 |
| 1013290766 | Minh V Nguy | Dentist | 3161 Senter Road, San Jose, CA 95121 | 2011-09-20 |
| 1528388139 | Vu V. Le Chiro | Chiropractor | 1059 E. Capitol Expressway, San Jose, CA 95121 | 2010-06-04 |
| 1205087012 | Lanni Huynh | Acupuncturist | 2936 Aborn Square, San Jose, CA 95121 | 2008-10-10 |
| 1598936676 | Soumya Shivanna | Dentist | 1620 E.capitol Expressway, Suite C, San Jose, CA 95121 | 2008-03-18 |
| 1144434903 | Jeremy D. Lai | Pharmacist | 1569 Lexann Avenue, Suite 104, San Jose, CA 95121 | 2007-05-10 |
| Find all providers in zip 95121 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013424217 | Bay Area Pediatric Primary Care Inc. | Pediatrics | 244 N Jackson Ave Ste 203, San Jose, CA 95116-1604 | 2018-01-09 |
| 1912399478 | Myron Lee Stone | Pediatrics | 2101 Forest Ave Ste 130, San Jose, CA 95128-1424 | 2015-02-20 |
| 1205243763 | George Shin Han | Pediatrics | 976 Lenzen Ave Ste 1100, San Jose, CA 95126-2737 | 2014-07-16 |
| 1033537006 | Sphoorti D. Umarjee | Pediatrics | 276 International Cir Fl 1, San Jose, CA 95119-1130 | 2014-04-06 |
| 1508209453 | Richard Anthony Cirone Sr. | Pediatrics | 1645 Peregrino Way, San Jose, CA 95125-4547 | 2013-04-10 |
| 1679812556 | Hien Van Nguyen | Pediatrics | 1675 Burdette Dr, Ste #20, San Jose, CA 95121 | 2013-02-12 |
| 1699034199 | Amina Ahmed | Pediatrics | 2577 Samaritan Dr Ste 830, San Jose, CA 95124-4109 | 2012-05-04 |
| 1801166442 | Catherine S Yao | Pediatrics | 750 South Bascom Avenue, San Jose, CA 95128 | 2012-01-12 |
| 1659677243 | Sundus Ali | Pediatrics | 6489 Camden Ave Ste 102, San Jose, CA 95120 | 2011-01-31 |
| 1134459852 | Priyansha Sen Jamwal | Pediatrics | 80 Descanso Dr Unit 1317, San Jose, CA 95134-1829 | 2009-12-31 |
| Find all providers in SAN JOSE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.