Provider Demographics
NPI:1649296393
Name:JENNY H. SAW, M.D., PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:JENNY H. SAW, M.D., PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PEDIATRICIAN, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:HTAY-HTAY-THAN
Authorized Official - Last Name:SAW-HSIAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD,
Authorized Official - Phone:408-923-8522
Mailing Address - Street 1:200 JOSE FIGUERES AVE STE 455
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1596
Mailing Address - Country:US
Mailing Address - Phone:408-923-8522
Mailing Address - Fax:408-923-8709
Practice Address - Street 1:200 JOSE FIGUERES AVE STE 455
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1596
Practice Address - Country:US
Practice Address - Phone:408-923-8522
Practice Address - Fax:408-923-8709
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA66727208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty