Basic Information
| Provider Information | |||||||||
| NPI: | 1982017802 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SILICON VALLEY CHEST & SLEEP MEDICINE INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 E REMINGTON DR | ||||||||
| Address2: | STE # 18 | ||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087308082 | ||||||||
| FaxNumber: | 4087300548 | ||||||||
| Practice Location | |||||||||
| Address1: | 500 E REMINGTON DR | ||||||||
| Address2: | STE # 18 | ||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940872657 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087308082 | ||||||||
| FaxNumber: | 4087300548 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/09/2014 | ||||||||
| LastUpdateDate: | 06/24/2017 | ||||||||
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| AuthorizedOfficialLastName: | SHETTY | ||||||||
| AuthorizedOfficialFirstName: | MAHESH | ||||||||
| AuthorizedOfficialMiddleName: | JAYA | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN / OWNER | ||||||||
| AuthorizedOfficialTelephone: | 4087308082 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD, MPH | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 129323 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | 129323 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RP1001X | 129323 | CA | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 207RS0012X | 129323 | CA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine |
No ID Information.