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AESTHETIC AND REFRACTIVE SURGERY MEDICAL CENTER INC. NPI 1124111711


NPI Information

NPI: 1124111711
Provider Name: AESTHETIC AND REFRACTIVE SURGERY MEDICAL CENTER, INC.
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
455 OCONNOR DR
SUITE 180B
SAN JOSE, CA
ZIP 95128
Phone: (408) 998-8109
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AESTHETIC AND REFRACTIVE SURGERY MEDICAL CENTER, INC. is a specialist in San Jose, CA. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. AESTHETIC AND REFRACTIVE SURGERY MEDICAL CENTER, INC. NPI is 1124111711. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

455 OCONNOR DR
SUITE 180B
SAN JOSE, CA
ZIP 95128-633
Phone: (408) 998-8109
Fax: (408) 998-1884

The provider's authorized official is Randal T Pham .
The authorized official title is Medical Director and has the following contact phone number (408) 998-0166.

The enumeration date for this NPI number is 10/2/2006 and was last updated on 6/30/2014.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistG071297CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G712971MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA
2F58293MEDICARE UPINCALIFORNIA
300G712970MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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