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Organization
EXECUTIVE ENDOSCOPY, INC.
Active
Organization
EXECUTIVE ENDOSCOPY, INC.
Active
Other names
ENDOSCOPY CENTER OF SAN JOSE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FELIX K. TAM M.D. (CLINIC DIRECTOR/SECRETARY OF ATF CO)
(408) 297-2314
Entity
Organization
Contact information
Practice address
2100 FOREST AVE, SUITE 109, SAN JOSE, CA 95128
(408) 297-2314
(408) 297-2414
Mailing address
2100 FOREST AVE, SUITE 109, SAN JOSE, CA 95128
(408) 297-2314
(408) 297-2414
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
070000639
CA
261QE0800X
Endoscopy Clinic/Center
—
CA
Other
Enumeration date
01/12/2007
Last updated
08/15/2008
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