PACIFIC REGENERATIVE AND INTERVENTIONAL SPORTS MEDICINE (NPI# 1952857823) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952857823 |
| Entity Type | Organization |
| Organization Name | PACIFIC REGENERATIVE AND INTERVENTIONAL SPORTS MEDICINE |
| Practice Address |
6080 Hellyer Ave Suite 100 San Jose CA 95138-1052 |
| Practice Telephone | 4084400930 |
| Practice Fax Number | 4084400389 |
| Mailing Telephone | 4084400930 |
| Mailing Fax Number | 4084400389 |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-09-06 |
| Authorized Official Name | DR. BRICE WILLIAM BLATZ (OWNER) |
| Authorized Official Telephone | 4084400930 |
| Authorized Official Credential | M.D., M.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM2500X |
Clinic/Center Specialization: Medical Specialty |
A124037 | CA | Ambulatory Health Care Facilities |
| Street Address |
6080 HELLYER AVE SUITE 100 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95138-1052 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851709984 | Reveal Diagnostics, LLC | Radiology | 6080 Hellyer Ave, Suite 175, San Jose, CA 95138-1052 | 2014-08-01 |
| 1568837060 | Prism | Clinic/Center | 6080 Hellyer Ave, Suite 100, San Jose, CA 95138-1052 | 2015-12-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023623865 | Nguyen and Tran Dental Corporation | Dentist | 6130 Hellyer Avenue, San Jose, CA 95138 | 2020-09-09 |
| 1821564485 | Indian Health Center of Santa Clara Valley | Clinic/Center | 9501 Malech Rd, San Jose, CA 95138 | 2018-10-22 |
| 1548690324 | Megan Chang | Occupational Therapist | 5900, Pistoia Way, San Jose, CA 95138 | 2013-11-15 |
| 1720428410 | Cristina Duenas | Social Worker | 5855 Silver Creek Valley Pl, San Jose, CA 95138 | 2013-06-27 |
| 1174967079 | Guardian Sleep Clinic, LLC | Clinical Medical Laboratory | 315 Piercy Rd, San Jose, CA 95138 | 2013-04-22 |
| 1871847889 | Rebecca Kerry Van Sickle | Counselor | 9500 Malech Rd, San Jose, CA 95138 | 2012-10-30 |
| 1366720906 | Ariosa Diagnostics, Inc. | Clinical Medical Laboratory | 5945 Optical Court, San Jose, CA 95138 | 2011-08-01 |
| 1043406713 | Umaru Fofana | Counselor | 455 Silicon Valley Blvd, San Jose, CA 95138 | 2007-09-17 |
| 1316140569 | Dickman & Bourla Chiropractic Inc | Chiropractor | 2311 Silver Breeze Ct, San Jose, CA 95138 | 2007-06-06 |
| 1508983032 | Traci Pickett | Counselor | 9500 Malech Road, San Jose, CA 95138 | 2007-03-22 |
| Find all providers in zip 95138 | ||||
| Taxonomy Code | 261QM2500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Medical Specialty |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275630816 | Charles Sheptin, Md, Inc. | Clinic/Center | 1792 Kirkmont Dr, San Jose, CA 95124-1235 | 2006-09-17 |
| 1740747427 | Srilakshmi Vemulakonda, Md Inc | Clinic/Center | 225 N Jackson Ave, San Jose, CA 95116-1603 | 2019-02-28 |
| 1649701384 | Uberwoundcare Inc | Clinic/Center | 2880 Zanker Rd, Suite 203, San Jose, CA 95134-2117 | 2017-03-24 |
| 1720448657 | Cancer and Blood Care of San Jose Inc | Clinic/Center | 175 N Jackson Ave, Suite 209, San Jose, CA 95116-1909 | 2016-03-04 |
| 1275878274 | Steven P. Vo, M.d., Inc. | Clinic/Center | 2114 Senter Rd, Ste 10, San Jose, CA 95112-2608 | 2012-12-01 |
| 1841598323 | Cardiology Clinic of Northern California | Clinic/Center | 969 Story Rd, Suite 6066, San Jose, CA 95122-2690 | 2011-03-07 |
| 1376869404 | Michael M Gold Md A Professional Medical Corporation | Clinic/Center | 2585 Samaritan Dr Ste 303, San Jose, CA 95124-4107 | 2010-04-14 |
| 1942526066 | David S. Hirschfeld, M.d., Inc. | Clinic/Center | 2585 Samaritan Dr Ste 303, San Jose, CA 95124-4107 | 2010-04-14 |
| 1215137963 | Jerry A. Hanson, M.d. A Professional Corporation | Clinic/Center | 2030 Forest Ave, Ste. 210, San Jose, CA 95128-4833 | 2007-07-20 |
| 1396949822 | Evergreen Hills Medical Group | Clinic/Center | 2690 S White Rd, Suite 200, San Jose, CA 95148-2076 | 2007-06-11 |
| 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.