Provider Demographics
NPI:1962575852
Name:REGIONAL MEDICAL CENTER OF SAN JOSE
Entity type:Organization
Organization Name:REGIONAL MEDICAL CENTER OF SAN JOSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASA
Authorized Official - Middle Name:
Authorized Official - Last Name:POPOVIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-259-5000
Mailing Address - Street 1:2628 MORAINE DR
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-1120
Mailing Address - Country:US
Mailing Address - Phone:408-249-4791
Mailing Address - Fax:
Practice Address - Street 1:225 N JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1603
Practice Address - Country:US
Practice Address - Phone:408-259-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA96234207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty