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Organization
SOUTH BAY ANGIOGRAPHY AND INTERVENTIONAL CENTER
Active
Organization
SOUTH BAY ANGIOGRAPHY AND INTERVENTIONAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. POLYXENE G KOKINOS M.D. (CEO)
(408) 376-3626
Entity
Organization
Contact information
Practice address
2255 S BASCOM AVE, SUITE 200, CAMPBELL, CA 95008-7800
(408) 376-3626
(408) 871-2377
Mailing address
2255 S BASCOM AVE, SUITE 200, CAMPBELL, CA 95008-7800
(408) 376-3626
(408) 871-2377
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
CA
2085R0202X
Diagnostic Radiology Physician
—
CA
2085R0204X
Vascular & Interventional Radiology Physician
—
CA
Other
Enumeration date
11/21/2016
Last updated
11/21/2016
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