Provider Demographics
NPI:1538981865
Name:CAMNY MEDICAL SERVICES WEST PC
Entity type:Organization
Organization Name:CAMNY MEDICAL SERVICES WEST PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTINE
Authorized Official - Middle Name:I
Authorized Official - Last Name:MCCOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:888-383-5881
Mailing Address - Street 1:99 SOUTH ALMADEN BLVD
Mailing Address - Street 2:SUITE 600
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95113
Mailing Address - Country:US
Mailing Address - Phone:888-383-5881
Mailing Address - Fax:
Practice Address - Street 1:99 SOUTH ALMADEN BLVD
Practice Address - Street 2:SUITE 600
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113
Practice Address - Country:US
Practice Address - Phone:888-383-5881
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-28
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty