Provider Demographics
NPI:1164880761
Name:SILICON VALLEY MEDICAL DEVELOPMENT LLC
Entity Type:Organization
Organization Name:SILICON VALLEY MEDICAL DEVELOPMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WALSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:650-940-7240
Mailing Address - Street 1:973 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-7636
Mailing Address - Country:US
Mailing Address - Phone:408-871-3200
Mailing Address - Fax:408-871-3201
Practice Address - Street 1:828 S WINCHESTER BLVD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2930
Practice Address - Country:US
Practice Address - Phone:408-871-3400
Practice Address - Fax:408-866-3999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-10
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-SpecialtyGroup - Single Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care