Provider Demographics
NPI:1174916357
Name:WENTWORTH PARTNERS INC.
Entity type:Organization
Organization Name:WENTWORTH PARTNERS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEERAJ
Authorized Official - Middle Name:
Authorized Official - Last Name:KOCHHAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-358-9917
Mailing Address - Street 1:15195 NATIONAL AVE
Mailing Address - Street 2:205
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-2631
Mailing Address - Country:US
Mailing Address - Phone:408-358-9917
Mailing Address - Fax:408-358-9927
Practice Address - Street 1:15195 NATIONAL AVE
Practice Address - Street 2:205
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-2631
Practice Address - Country:US
Practice Address - Phone:408-358-9917
Practice Address - Fax:408-358-9927
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-11
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA71261207L00000X
CAA72560207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH22680Medicare UPIN