Provider Demographics
NPI:1174202097
Name:OVERSIGHTMD INC.
Entity type:Organization
Organization Name:OVERSIGHTMD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:GODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-509-2500
Mailing Address - Street 1:1525 MCCARTHY BLVD STE 1000
Mailing Address - Street 2:
Mailing Address - City:MILPITAS
Mailing Address - State:CA
Mailing Address - Zip Code:95035-7451
Mailing Address - Country:US
Mailing Address - Phone:408-509-2500
Mailing Address - Fax:
Practice Address - Street 1:1525 MCCARTHY BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-7451
Practice Address - Country:US
Practice Address - Phone:408-509-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase Management
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty