Provider Demographics
NPI:1285688267
Name:SAN JOSE HEALTHCARE SYSTEM, L.P.
Entity Type:Organization
Organization Name:SAN JOSE HEALTHCARE SYSTEM, L.P.
Other - Org Name:REGIONAL MEDICAL CENTER OF SAN JOSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHWORTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-729-2860
Mailing Address - Street 1:225 N JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1603
Mailing Address - Country:US
Mailing Address - Phone:408-259-5000
Mailing Address - Fax:408-729-2884
Practice Address - Street 1:225 N JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116
Practice Address - Country:US
Practice Address - Phone:408-259-5000
Practice Address - Fax:408-729-2884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-22
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHSC00125GMedicaid
CA050125OtherBLUE SHIELD
CA050125OtherBLUE CROSS
NV100507202Medicaid
CAHSC00125GMedicaid
CA050125OtherBLUE CROSS