MINIMALLY INVASIVE SURGICAL SOLUTIONS MEDICAL CORPORATION (NPI# 1821167628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821167628 |
| Entity Type | Organization |
| Organization Name | MINIMALLY INVASIVE SURGICAL SOLUTIONS MEDICAL CORPORATION |
| Practice Address |
105 N. Bascom Ave 104 San Jose CA 95128-1633 |
| Mailing Address |
105 N Bascom Ave Ste 104 San Jose CA 95128-1811 |
| Practice Telephone | 4089180405 |
| Practice Fax Number | 4089180409 |
| Mailing Telephone | 4089180405 |
| Mailing Fax Number | 4089180409 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2020-01-28 |
| Authorized Official Name | RIKKI QUEVEDO (FINANCIAL AND CREDENTIALING COORDIN) |
| Authorized Official Telephone | 4089180405 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
G74857 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GR0095460 | 05 |
| Street Address |
105 N. BASCOM AVE 104 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-1633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891739348 | Reza Malek | Specialist | 105 N. Bascom Ave, Ste 104, San Jose, CA 95128 | 2006-06-15 |
| 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 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548730500 | Vip Vascular Interventional Centers PC | Radiology | 2410 Samaritan Dr Ste 101, San Jose, CA 95124-3909 | 2018-12-03 |
| 1427497775 | Ir Solutions Inc Medical Corp | Radiology | 105 N Bascom Ave, Suite 104, San Jose, CA 95128-1811 | 2013-06-20 |
| 1336441310 | Vip Vein Center | Radiology | 2410 Samaritan Dr, Suite 102, San Jose, CA 95124-3909 | 2010-11-24 |
| 1861629453 | Lindsey Jane Bergren Pierce | Radiology | 105 N Bascom Ave, Suite 104, San Jose, CA 95128-1811 | 2009-06-22 |
| 1194913897 | Interventional Vascular Institute of San Jose, LLC | Radiology | 105 N Bascom Ave, San Jose, CA 95128-1811 | 2007-10-09 |
| 1326246059 | Marcos Alvarez II | Radiology | 2375 Forest Ave, San Jose, CA 95128-4610 | 2007-07-03 |
| 1295811727 | Mark K. Sarkisian | Radiology | 260 International Cir, San Jose, CA 95119-1130 | 2006-10-27 |
| 1730265240 | David Madwed | Radiology | 260 International Cir, San Jose, CA 95119-1130 | 2006-10-27 |
| 1669486700 | Paul R Cipriano | Radiology | 105 N Bascom Ave, Ste 104, San Jose, CA 95128 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739949 | Ava Vascular | Radiology | 1281 W. C. Street, Suite 200, Colton, CA 92324 | 2020-08-06 |
| 1306467204 | Saleh Radiology of Inland Empire | Radiology | 15276 Ledgestone St, Fontana, CA 92336-4048 | 2020-05-01 |
| 1366084535 | Luo Xu | Radiology | 757 Westwood Plz # 2146, Los Angeles, CA 90095-8358 | 2019-10-09 |
| 1346717824 | Cvs Medical Group, Inc | Radiology | 201 W Garvey Ave Ste 102-502, Monterey Park, CA 91754-7418 | 2018-11-01 |
| 1407353675 | Art Vascular & Interventional Associates Inc | Radiology | 324 S Beverly Dr Ste 345, Beverly Hills, CA 90212-4801 | 2018-04-12 |
| 1568971869 | Broad Reach Specialty Surgery Inc | Radiology | 8117 West Manchester Ave, Ste 368, Playa Del Rey, CA 90293 | 2017-09-29 |
| 1407393754 | Valley Vascular Partners Inc | Radiology | 19231 Victory Blvd Ste 155, Reseda, CA 91335-6329 | 2017-01-25 |
| 1124497342 | Neurointerventional Surgery Consultants, PC | Radiology | 534 S Brea Blvd, Brea, CA 92821-5304 | 2015-09-17 |
| 1578946026 | Clarity Radiology, LLC | Radiology | 39 Via Navarro, Greenbrae, CA 94904-1215 | 2015-07-01 |
| 1669863981 | Pedes Vascular San Fernando Valley | Radiology | 16260 Ventura Boulevard, Suite 210, Encino, CA 91436-2203 | 2015-02-09 |
| Find all providers with the same taxonomy | ||||
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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.