Provider Demographics
NPI:1083796510
Name:CLAUDIO S CONTRERAS MD INC
Entity Type:Organization
Organization Name:CLAUDIO S CONTRERAS MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT-CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAUDIO
Authorized Official - Middle Name:S
Authorized Official - Last Name:CONTRERAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-971-2020
Mailing Address - Street 1:2120 MCKEE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1427
Mailing Address - Country:US
Mailing Address - Phone:408-971-2020
Mailing Address - Fax:
Practice Address - Street 1:2120 MCKEE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1427
Practice Address - Country:US
Practice Address - Phone:408-971-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-20
Last Update Date:2020-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG63436207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G634360Medicaid
CAP00031038OtherRAILROAD MEDICARE
CA00G634360Medicaid
CAZZZ26022ZMedicare PIN
CAZZZ26022ZMedicare ID - Type UnspecifiedGROUP NUMBER