MERIDIAN MEDICAL GROUP PROFESSIONAL CORP NPI 1457439572

NPI Information

MERIDIAN MEDICAL GROUP PROFESSIONAL CORP is a general practice in San Jose, CA. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee MERIDIAN MEDICAL GROUP PROFESSIONAL CORP NPI is 1457439572. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Meridian Medical Group.

The provider's business location address is:

1047 E CAPITOL EXPY
SAN JOSE, CA
ZIP 95121-415
Phone: (408) 754-8988
Fax: (408) 754-8289

The provider's authorized official is Albert A Gomez .
The authorized official title is Ceo and has the following contact phone number (408) 754-8988.

The CLIA number assigned to this NPI record is 05D2077497 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 11/2/2006 and was last updated on 3/29/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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