Provider Demographics
NPI:1962531590
Name:ALLERGY & ASTHMA ASSOCIATES OF SANTA CLARA VALLEY A MEDICAL CORP
Entity type:Organization
Organization Name:ALLERGY & ASTHMA ASSOCIATES OF SANTA CLARA VALLEY A MEDICAL CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-243-2700
Mailing Address - Street 1:4050 MOORPARK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1840
Mailing Address - Country:US
Mailing Address - Phone:408-243-2700
Mailing Address - Fax:408-553-0750
Practice Address - Street 1:4050 MOORPARK AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95117
Practice Address - Country:US
Practice Address - Phone:408-243-2700
Practice Address - Fax:408-553-0750
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ19714ZMedicare PIN
CAZZZ19715ZMedicare PIN
CAZZZ19709ZMedicare PIN
CAZZZ19713ZMedicare PIN
CAZZZ19712ZMedicare PIN
CAZZZ81559ZMedicare ID - Type Unspecified