Acute Behavioral Medical Group Of California, INC.
Hospitalist in San Jose, CA. Organization (NPI-2).
NPI number1124741095
StatusActive
Last updated in NPPESSep 26, 2022
Details
- NPI
- 1124741095
- Entity type
- Organization (NPI-2)
- Legal business name
- Acute Behavioral Medical Group Of California, INC.
- Organization subpart
- No
- Enumeration date
- Sep 26, 2022
- Certification date
- Sep 24, 2022
- Last updated
- Sep 26, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208M00000X | Hospitalist | – | – | Yes |
| 207Q00000X | Family Medicine | – | – | |
| 207R00000X | Internal Medicine | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
2425 Samaritan DrSan Jose, CA 95124-3908
Phone 408-559-2011
Mailing address
1643 Nw 136th AveBldg. H, Suite 100
Sunrise, FL 33323-2857
Phone 954-377-2909 · Fax 865-560-7089
Authorized official
Gonzalo Perez-Garcia
President
3543772909
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