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Organization
MINIMALLY INVASIVE SURGICAL SOLUTIONS MEDICAL CORPORATION
Active
Organization
MINIMALLY INVASIVE SURGICAL SOLUTIONS MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIA ANDRADE (CREDENTIALING COORDINATOR)
(408) 918-0405
Entity
Organization
Contact information
Practice address
105 N BASCOM AVE STE 104, SAN JOSE, CA 95128-1811
(408) 918-0405
(408) 918-0409
Mailing address
105 N BASCOM AVE STE 104, SAN JOSE, CA 95128-1811
(408) 918-0405
(408) 918-0409
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0095460
—
CA
Enumeration date
11/07/2006
Last updated
06/10/2025
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