Provider Demographics
NPI:1568538247
Name:PAZ, GOTAMI
Entity Type:Individual
Prefix:MS
First Name:GOTAMI
Middle Name:
Last Name:PAZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TAMI
Other - Middle Name:
Other - Last Name:PAZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1468 FOUR OAKS CIR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95131-2644
Mailing Address - Country:US
Mailing Address - Phone:408-280-2633
Mailing Address - Fax:
Practice Address - Street 1:1468 FOUR OAKS CIR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95131-2644
Practice Address - Country:US
Practice Address - Phone:408-280-2633
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41917OtherUNICARE