Organization
TRI DO MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRI DO MD (CEO)
(408) 835-9601
Entity
Organization
Contact information
Practice address
5091 MITTY WAY, SAN JOSE, CA 95129-1849
(408) 835-9601
Mailing address
5091 MITTY WAY, SAN JOSE, CA 95129-1849
(408) 835-9601
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1619930260
TYPE 1 NPI
CA
01
—
A55472
CA MEDICAL LICENSE
CA
Enumeration date
10/20/2022
Last updated
10/20/2022
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