EVERGREEN MEDICAL GROUP, INC. (NPI# 1508159294) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508159294 |
| Entity Type | Organization |
| Organization Name | EVERGREEN MEDICAL GROUP, INC. |
| Practice Address |
2690 S White Rd Ste 50 San Jose CA 95148-2075 |
| Practice Telephone | 4082237000 |
| Practice Fax Number | 4082237001 |
| Mailing Telephone | 4082237000 |
| Mailing Fax Number | 4082237001 |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2012-03-05 |
| Authorized Official Name | DR. LILY KAO (PHYSICIAN) |
| Authorized Official Telephone | 4082237000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
A100943 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2690 S WHITE RD STE 50 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95148-2075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740284249 | Smita Gupta | Internal Medicine | 2690 S White Rd Ste 50, San Jose, CA 95148-2075 | 2005-06-13 |
| 1205491594 | Amanda Flohr | Physician Assistant | 2690 S White Rd Ste 50, San Jose, CA 95148-2075 | 2019-05-02 |
| 1487167912 | Vivian Diep | Physician Assistant | 2690 S White Rd Ste 50, San Jose, CA 95148-2075 | 2017-11-06 |
| 1457892101 | Joyce Valencia | Nurse Practitioner | 2690 S White Rd Ste 50, San Jose, CA 95148 | 2017-03-14 |
| 1174707392 | Anjali Jain | Pediatrics | 2690 S White Rd Ste 50, San Jose, CA 95148-2075 | 2007-12-24 |
| 1578742888 | Lily Kao | Internal Medicine | 2690 S White Rd Ste 50, San Jose, CA 95148 | 2007-11-02 |
| 1245437433 | Thu Phuong Ho | Pediatrics | 2690 S White Rd Ste 50, San Jose, CA 95148-2075 | 2007-06-29 |
| 1164554051 | Anuradhika Kandula | Internal Medicine | 2690 S White Rd Ste 50, San Jose, CA 95148-2075 | 2007-03-09 |
| 1801813720 | Joselito C Cabaccan | Internal Medicine | 2690 S White Rd Ste 50, San Jose, CA 95148-2075 | 2006-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902415540 | World Trekker LLC | Home Health | 2756 White Acres Drive, San Jose, CA 95148 | 2020-07-29 |
| 1962932749 | Mychau Nhu Nguyen | Acupuncturist | 2710 Gumdrop Drive, San Jose, CA 95148 | 2017-06-14 |
| 1457705808 | Dzuy V Bi | Optometrist | 2670 S White Rd Ste 200, San Jose, CA 95148 | 2016-04-21 |
| 1235489626 | Emerlyn Sangha | Dental Hygienist | 1878 Oakton Court, San Jose, CA 95148 | 2012-09-13 |
| 1073863502 | Uyen-ly Hoang Nguyen | Counselor | 2792 White Acres Dr, San Jose, CA 95148 | 2012-09-12 |
| 1780955880 | Tiffany Thy Nguyen | Pharmacist | 3121 Norwood Avenue, San Jose, CA 95148 | 2012-01-20 |
| 1215204722 | Stacey Nguyen | Pharmacist | 2799 S. White Road, San Jose, CA 95148 | 2011-11-28 |
| 1760670798 | Jamie Victoria Santiago | Chiropractor | 8010 Wayland Ln. Ste 1b, Gilroy, CA 95148 | 2007-10-03 |
| 1003021494 | Rosemary Evans | Dentist | 2680 S White Road, Suite 100, San Jose, CA 95148 | 2007-05-11 |
| 1942334073 | Evelyn Gaviola | Physical Therapist | 2670 S White Rd Ste 120, San Jose, CA 95148 | 2007-03-14 |
| Find all providers in zip 95148 | ||||
| Taxonomy Code | 207RR0500X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Rheumatology |
| An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and "collagen" diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962669747 | Yong Sook Lynda Lee Md | Internal Medicine | 2512 Samaritan Ct Ste P, San Jose, CA 95124-4002 | 2008-05-20 |
| 1275519092 | Jennifer Lee | Internal Medicine | 270 International Cir, Two North, 2nd Floor, Dept. of Rheumatology, San Jose, CA 95119-1130 | 2005-12-22 |
| 1558366047 | Bruce J Dreyfuss | Internal Medicine | 25 N 14th St, Ste 890, San Jose, CA 95112-6216 | 2005-06-20 |
| 1386199446 | Khurram Abbass Md Inc | Internal Medicine | 200 Jose Figueres Ave Ste 480, San Jose, CA 95116 | 2016-08-18 |
| 1316333065 | Alice Tung Chuang | Internal Medicine | 751 S Bascom Ave, San Jose, CA 95128-2604 | 2015-04-09 |
| 1841623733 | Bay Area Arthritis Care, Inc., A Medical Group | Internal Medicine | 2242 Camden Ave, Suite 203, San Jose, CA 95124-2029 | 2013-08-14 |
| 1528369618 | Arthritis Care Center Inc | Internal Medicine | 1835 Park Ave, San Jose, CA 95126-1650 | 2010-11-05 |
| 1841326386 | Jan Lin | Internal Medicine | 260 International Cir, San Jose, CA 95119-1130 | 2007-02-27 |
| 1699853267 | Henry T. Co | Internal Medicine | 260 International Cir, San Jose, CA 95119-1130 | 2006-11-01 |
| 1497839864 | Yong Sook Lynda Lee | Internal Medicine | 2512 Samaritan Ct, Ste P, San Jose, CA 95124 | 2006-10-24 |
| 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.