Provider Demographics
NPI:1487950903
Name:PRIMARY CARE AND GERIATRICS INC
Entity type:Organization
Organization Name:PRIMARY CARE AND GERIATRICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANAKHA
Authorized Official - Middle Name:R
Authorized Official - Last Name:NAMBIAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-536-9288
Mailing Address - Street 1:PO BOX 321092
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-0118
Mailing Address - Country:US
Mailing Address - Phone:281-536-9288
Mailing Address - Fax:
Practice Address - Street 1:700 W PARR AVE
Practice Address - Street 2:SUITE B
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-1442
Practice Address - Country:US
Practice Address - Phone:408-871-9100
Practice Address - Fax:408-871-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-31
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC54283207Q00000X, 207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty