Provider Demographics
NPI:1427019355
Name:WESTGATE FAMILY PHYSICIANS
Entity Type:Organization
Organization Name:WESTGATE FAMILY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGEING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:SLATER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-342-1040
Mailing Address - Street 1:5150 GRAVES AVE
Mailing Address - Street 2:BLDG 2
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-5013
Mailing Address - Country:US
Mailing Address - Phone:408-342-1040
Mailing Address - Fax:408-342-1045
Practice Address - Street 1:5150 GRAVES AVE
Practice Address - Street 2:BLDG 2
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-5013
Practice Address - Country:US
Practice Address - Phone:408-342-1040
Practice Address - Fax:408-342-1045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-30
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ54850ZOtherBLUESHIELD
CACJ5248OtherMEDICARE RAIL ROAD
CAZZZ54850ZOtherBLUESHIELD