Provider Demographics
NPI:1548573744
Name:HENRY J. FEE MD MEDICAL CORPORATION
Entity Type:Organization
Organization Name:HENRY J. FEE MD MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:FEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-358-8771
Mailing Address - Street 1:14911 NATIONAL AVE
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2632
Mailing Address - Country:US
Mailing Address - Phone:408-358-8771
Mailing Address - Fax:
Practice Address - Street 1:14911 NATIONAL AVE
Practice Address - Street 2:SUITE 6
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2632
Practice Address - Country:US
Practice Address - Phone:408-358-8771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-16
Last Update Date:2010-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG286280208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Single Specialty