Organization
EVERGREEN PEDIATRICS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRONOTI NIGAM M.D. (PHYSICIAN)
(408) 238-8303
Entity
Organization
Contact information
Practice address
4205 SAN FELIPE RD, #110, SAN JOSE, CA 95135-1503
(408) 238-8303
(408) 238-8375
Mailing address
4205 SAN FELIPE RD, #110, SAN JOSE, CA 95135-1503
(408) 238-8303
(408) 238-8375
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A33613
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A336130
—
CA
05
—
00C431251
—
CA
01
—
1053390310
PRONOTI NIGAM MD NPI
CA
01
—
1750497608
ZAHIDA P MALIKMD NPI
CA
01
—
R09208
BLUE CROSS MEDICAL
CA
01
—
R09238
BLUE CROSS MEDICAL
—
Enumeration date
02/02/2007
Last updated
10/02/2013
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