DR. ABID CHRISTOPHER MOGANNAM (NPI# 1598056483) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598056483 |
| Entity Type | Individual |
| Full Name | DR. ABID CHRISTOPHER MOGANNAM |
| Credential | M.D., M.B.A. |
| Practice Address |
2425 Samaritan Dr San Jose CA 95124 |
| Mailing Address |
1900 Camden Ave Ste 101 San Jose CA 95124-2944 |
| Practice Telephone | 4085592011 |
| Mailing Telephone | 4088998272 |
| Mailing Fax Number | 4084425767 |
| Enumeration Date | 2011-04-26 |
| Last Update Date | 2019-01-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | A123990 | CA | Allopathic & Osteopathic Physicians |
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
A123990 | CA | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
LT15520 | ND | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2425 Samaritan Dr, San Jose, CA 95124 | 4085592011 |
| Street Address |
2425 SAMARITAN DR |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356319347 | Brita Hellman | Physical Therapist | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2006-03-08 |
| 1194326835 | Elika F Leitch | Respiratory Therapist, Registered | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2020-11-07 |
| 1346847548 | Ravi K Aggusher Md Inc | Internal Medicine | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2020-10-01 |
| 1437700200 | Nicole Leann Dominguez | Social Worker | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2019-09-24 |
| 1003396474 | Harramanjoyt Hans-brar | Dietitian, Registered | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2018-08-15 |
| 1760972491 | Jillian Alexandra Wesselman | Registered Nurse | 2425 Samaritan Dr, San Jose, CA 95124 | 2018-05-17 |
| 1720580160 | Dana Janine Schroeder | Nurse Practitioner | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2018-03-01 |
| 1689192833 | Cep America - Anesthesia PC | Anesthesiology | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2017-09-07 |
| 1336678143 | California Emergency Physicians Medical Group, A Professional Corp | Internal Medicine | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2017-06-06 |
| 1306398482 | Rekha Dharmaji Md Inc | Internal Medicine | 2425 Samaritan Dr, San Jose, CA 95124-3908 | 2016-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720548894 | Talkawhile Child and Family Therapy Center PC | Marriage & Family Therapist | 2577 Samaritain Drive, Suite 715, San Jose, CA 95124 | 2019-03-23 |
| 1558847129 | Anne Marie Hamilton | Nurse Practitioner | 2851 Samaritan Dr., San Jose, CA 95124 | 2018-07-17 |
| 1619488665 | Vicky Nguyen | Dentist | 3994 S Bascom Ave # 5, San Jose, CA 95124 | 2017-10-17 |
| 1255840625 | Emmanuel Rohani | Pharmacist | 4623 Fallstone Court, San Jose, CA 95124 | 2017-09-28 |
| 1669928933 | Karlena Lara-otero | Genetic Counselor, MS | 2589 Samaritan Drive, Floor 3, Mail Code: 7532, San Jose, CA 95124 | 2016-08-28 |
| 1982081287 | Shraddha Patel | Dietitian, Registered | 3535 Ross Ave Ste 202, San Jose, CA 95124 | 2015-05-06 |
| 1679966576 | Andrew Francis | Marriage & Family Therapist | 1936 Camden Ave Ste 5a, San Jose, CA 95124 | 2015-03-17 |
| 1164835914 | Addiction Recovery Center | Clinic/Center | 3880 S. Bascom Ave #206, San Jose, CA 95124 | 2014-06-10 |
| 1780005199 | Swathi Balantrapu | Physical Therapist | 14587 Branham Ln, San Jose, CA 95124 | 2014-01-02 |
| 1033405196 | Rick Li Pan | Dentist | 3535 Ross Ave, #201, San Jose, CA 95124 | 2011-06-27 |
| Find all providers in zip 95124 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104847656 | Richard W Starrett | Surgery | 2512 Samaritan Ct Ste E, San Jose, CA 95124-4002 | 2006-07-21 |
| 1861413320 | John Gray Brawley IIi | Surgery | 751 S. Bascom Avenue Ste 340, Valley Specialty Center, Division of Vascular Surgery, San Jose, CA 95128 | 2006-07-21 |
| 1811994445 | Emil A. Anaya | Surgery | 105 N Bascom Ave, Ste 104, San Jose, CA 95128 | 2005-06-28 |
| 1871627463 | Emil A Anaya Md, Inc. A Medical Corporation | Surgery | 105 N Bascom Ave, Suite 104, San Jose, CA 95128-1811 | 2007-03-15 |
| 1730229261 | Glenn R. Romualdo | Surgery | 260 International Cir, San Jose, CA 95119-1130 | 2007-02-07 |
| 1013060672 | Vascular Associates of Northern California | Surgery | 2512 Samaritan Ct Ste E, San Jose, CA 95124-4002 | 2007-01-18 |
| 1235215740 | Everett Y. Lam | Surgery | 260 International Cir, San Jose, CA 95119-1130 | 2006-10-27 |
| 1366463812 | Roger M Hayashi | Surgery | 2512 Samaritan Ct Ste E, San Jose, CA 95124-4002 | 2006-07-21 |
| 1265453724 | David W Chang | Surgery | 2512 Samaritan Ct, Suite E, San Jose, CA 95124-4002 | 2006-07-21 |
| 1942238241 | Peter J Schubart | Surgery | 455 Oconnor Dr, Suite 370, San Jose, CA 95128-1633 | 2006-06-28 |
| 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.