Provider Demographics
NPI:1811179062
Name:NUCLEAR MEDICINE IMAGING OF SAN JOSE, INC
Entity type:Organization
Organization Name:NUCLEAR MEDICINE IMAGING OF SAN JOSE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PUNEET
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANDAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-595-8687
Mailing Address - Street 1:39120 ARGONAUT WAY STE 827
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1304
Mailing Address - Country:US
Mailing Address - Phone:510-792-9700
Mailing Address - Fax:
Practice Address - Street 1:333 SANTANA ROW APT 223
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2007
Practice Address - Country:US
Practice Address - Phone:415-595-8687
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA79514207U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Multi-Specialty