# BLUE SKY SURGICAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104714963
- **Authorized official:** JENNY PHAN (OWNER)
- **Authorized official phone:** (650) 935-4745

## Contact information

- **Practice address:** 2951 WALL ST, SAN JOSE, CA 95111-4600
- **Practice address phone:** (408) 603-6553
- **Mailing address:** 2951 WALL ST, SAN JOSE, CA 95111-4600
- **Mailing address phone:** (650) 935-4745

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WR0006X | Registered Nurse First Assistant | — | NULL | Yes |
| 163WR0006X | Registered Nurse First Assistant | — | — | Yes |
| 251J00000X | Nursing Care Agency | — | NULL | — |

## Other

- **Enumeration date:** 06/27/2025
- **Last updated:** 11/15/2025