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EVERGREEN PEDIATRICS INC NPI 1972641736


NPI Information

NPI: 1972641736
Provider Name: EVERGREEN PEDIATRICS INC
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
4205 SAN FELIPE RD
#110
SAN JOSE, CA
ZIP 95135
Phone: (408) 238-8303
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EVERGREEN PEDIATRICS INC is a pediatrics in San Jose, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. EVERGREEN PEDIATRICS INC NPI is 1972641736. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

4205 SAN FELIPE RD
#110
SAN JOSE, CA
ZIP 95135-503
Phone: (408) 238-8303
Fax: (408) 238-8375

The provider's authorized official is Pronoti Nigam .
The authorized official title is Physician and has the following contact phone number (408) 238-8303.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 10/2/2013.


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
1208000000XPediatricsA33613CALIFORNIAYes

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
1R09208OTHERCALIFORNIABLUE CROSS MEDICAL
21053390310OTHERCALIFORNIAPRONOTI NIGAM MD NPI
3R09238OTHERBLUE CROSS MEDICAL
41750497608OTHERCALIFORNIAZAHIDA P MALIKMD NPI
500A336130MEDICAIDCALIFORNIA
600C431251MEDICAIDCALIFORNIA

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: 4/28/2024

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