Provider Demographics
NPI:1477503381
Name:SAN JOSE CARDIAC SURGERY GRP
Entity Type:Organization
Organization Name:SAN JOSE CARDIAC SURGERY GRP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-559-1018
Mailing Address - Street 1:15215 NATIONAL AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2425
Mailing Address - Country:US
Mailing Address - Phone:408-559-1018
Mailing Address - Fax:408-371-3025
Practice Address - Street 1:15215 NATIONAL AVE STE 103
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2425
Practice Address - Country:US
Practice Address - Phone:408-559-1018
Practice Address - Fax:408-371-3025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-11
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ16883ZOtherBLUE SHIELD
00G630840OtherMEDI-CAL
EG63084OtherCHAMPUS
CACN5287OtherRAILROAD MEDICARE
00C382510OtherMEDI-CAL
00G488080OtherMEDI-CAL
EG48808OtherCHAMPUS
HC382510OtherHMO
CAGR0081260Medicaid
HG48808OtherHMO
HG63084OtherHMO
PG48808OtherPPO
PG63084OtherPPO
EG63084OtherCHAMPUS
A53726Medicare UPIN
00G488080Medicare ID - Type Unspecified
CACN5287OtherRAILROAD MEDICARE
CAZZZ14450ZMedicare ID - Type Unspecified
CAGR0081260Medicaid
C97604Medicare UPIN