EXECUTIVE ENDOSCOPY, INC.


Address: 2100 Forest Ave, Suite 109, San Jose, CA 95128
Phone: 4082972314

EXECUTIVE ENDOSCOPY, INC. (NPI# 1598815110) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1598815110
Entity Type Organization
Organization Name EXECUTIVE ENDOSCOPY, INC.
Other Organization Name ENDOSCOPY CENTER OF SAN JOSE
Practice Address 2100 Forest Ave
Suite 109
San Jose
CA 95128
Practice Telephone 4082972314
Practice Fax Number 4082972414
Mailing Telephone 4082972314
Mailing Fax Number 4082972414
Enumeration Date 2007-01-12
Last Update Date 2008-08-15
Authorized Official Name DR. FELIX K. TAM (CLINIC DIRECTOR/SECRETARY OF ATF CO)
Authorized Official Telephone 4082972314
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 261QE0800X Clinic/Center
Specialization: Endoscopy
CA Ambulatory Health Care Facilities
Y 261QA1903X Clinic/Center
Specialization: Ambulatory Surgical
070000639 CA Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
CA SUR01553F 05

Other Provider/Organization Names

Other Name Type Code
ENDOSCOPY CENTER OF SAN JOSE Other Name - Individual/Organization

Office Location

Street Address 2100 FOREST AVE
SUITE 109
City SAN JOSE
State CA
Zip Code 95128

Providers in the same location

NPI Name Taxonomy Address Enumeration
1194712109 Executive Endoscopy, Inc Clinic/Center 2100 Forest Ave, 109, San Jose, CA 95128-1422 2005-10-04
1184146714 Mona Mukesh Joshi Optometrist 2100 Forest Ave, Ste 110, San Jose, CA 95128-1422 2017-07-14
1871712174 Forest Avenue Medical Group Internal Medicine 2100 Forest Ave, Suite 104, San Jose, CA 95128-1422 2007-04-25
1174655633 Michael Francis Martin Internal Medicine 2100 Forest Ave, Suite 104, San Jose, CA 95128-1422 2007-03-11
1801925151 Thomas James Mcguire Internal Medicine 2100 Forest Ave, Suite 104, San Jose, CA 95128-1422 2007-03-05
1942373998 David W Chui Internal Medicine 2100 Forest Ave, 102, San Jose, CA 95128-1422 2006-11-16
1700955143 Michael Tandick Charney Internal Medicine 2100 Forest Ave, #106, San Jose, CA 95128-1422 2006-11-07
1639265770 Robert Edmond Neger Ophthalmology 2100 Forest Ave, Suite 110, San Jose, CA 95128-1422 2006-10-05
1548363112 Harold Allen Rodgers Dermatology 2100 Forest Ave, #103, San Jose, CA 95128-1422 2006-09-07
1023122959 David H Eby Jr. Internal Medicine 2100 Forest Ave, Suite 104, San Jose, CA 95128 2006-08-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1982227138 Ruth Larsen Social Worker 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 2020-05-22
1265067185 Of Two Minds Psychotherapy Marriage & Family Therapist 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 2020-03-11
1982244166 Cindy Pantoja Escobar Behavior Technician 100 O'connor Drive, Suites 21, San Jose, CA 95128 2020-01-15
1104460591 Katherine Alexandra Misogas Pharmacist 777 Turner Dr # 330, San Jose, CA 95128 2019-10-29
1942842216 Jodie Pierce Marriage & Family Therapist 871 Enborg Lane, San Jose, CA 95128 2019-10-08
1003466434 Dong Mi Cha Pharmacist 777 Turner Dr Ste 330, San Jose, CA 95128 2019-09-17
1114571759 Sleep Well Acupuncture, Inc Acupuncturist 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 2019-08-01
1083277677 Wellocity, Inc Health Educator 334 Santana Row, 318, San Jose, CA 95128 2019-04-18
1518428812 Alexander Diaz Radiology 75 South Bascom Ave, San Jose, CA 95128 2019-03-28
1720542103 Nanci R Price Inc Chiropractor 100 O'connor Dr., Ste 27, San Jose, CA 95128 2019-01-30
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Taxonomy Information

Taxonomy Code 261QA1903X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Ambulatory Surgical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1538775267 Ev Surgery Institute LLC Clinic/Center 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 2020-09-18
1588131395 Baasc Clinic/Center 4215 Hamilton Ave, San Jose, CA 95130-1462 2018-10-30
1295213734 Los Gatos Surgical Center, A California Limited Partnership Clinic/Center 2410 Samaritan Dr Ste 100, San Jose, CA 95124-3909 2018-08-06
1538618368 Evergreen Surgery Center, LLC Clinic/Center 2365 Quimby Rd Ste 180, San Jose, CA 95122-1337 2016-09-21
1801269121 Silver Creek Surgery Ctr LLC Clinic/Center 6010 Hellyer Ave, Suite 100, San Jose, CA 95138-1014 2015-11-09
1891837415 Plastic & Reconstructive Surgery Center Clinic/Center 2581 Samaritan Dr Ste 102, San Jose, CA 95124-4112 2007-02-12
1508942996 Physicians Surgery Services Lp Clinic/Center 235 Oconnor Dr, San Jose, CA 95128-1624 2006-10-27
1194712109 Executive Endoscopy, Inc Clinic/Center 2100 Forest Ave, 109, San Jose, CA 95128-1422 2005-10-04
1568837060 Prism Clinic/Center 6080 Hellyer Ave, Suite 100, San Jose, CA 95138-1052 2015-12-09
1770951915 Tri-county Vascular Care, LLC Clinic/Center 393 Blossom Hill Rd, San Jose, CA 95123-1652 2015-09-03
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Competitor

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City SAN JOSE
Zip Code 95128

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Dataset Information

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.

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