Provider Demographics
NPI:1780793497
Name:INSPIRE MEDICAL GROUP OF SAN JOSE PC
Entity type:Organization
Organization Name:INSPIRE MEDICAL GROUP OF SAN JOSE PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:949-694-5700
Mailing Address - Street 1:21 ORCHARD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-8300
Mailing Address - Country:US
Mailing Address - Phone:408-297-8600
Mailing Address - Fax:408-297-5643
Practice Address - Street 1:2039 FOREST AVE STE 308
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-4830
Practice Address - Country:US
Practice Address - Phone:408-297-8600
Practice Address - Fax:408-297-5643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG69347OtherMEDICAL BOARD OF CALIFORNIA
A26663Medicare UPIN