Provider Demographics
NPI:1144432832
Name:UROLOGY ASSOCIATES OF SILICON VALLEY
Entity type:Organization
Organization Name:UROLOGY ASSOCIATES OF SILICON VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERSTEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-358-2030
Mailing Address - Street 1:2581 SAMARITAN DR
Mailing Address - Street 2:STE 200
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95124
Mailing Address - Country:US
Mailing Address - Phone:408-358-2030
Mailing Address - Fax:408-358-2036
Practice Address - Street 1:2581 SAMARITAN DR
Practice Address - Street 2:STE 200
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124
Practice Address - Country:US
Practice Address - Phone:408-358-2030
Practice Address - Fax:408-358-2036
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA208800000X, 2088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
Not Answered2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1346313210OtherNPI ROBERT P PANVINI
1932272804OtherSHAHRAM S GHOLAMI
1679646533OtherNPI JOHN KERSTEN KRAFT
1912070889OtherNPI DAVID M NUDELL
1679646533OtherNPI JOHN KERSTEN KRAFT
1912070889OtherNPI DAVID M NUDELL
1346313210OtherNPI ROBERT P PANVINI
1932272804OtherSHAHRAM S GHOLAMI