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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