Healthcare Provider Details
I. General information
NPI: 1053334698
Provider Name (Legal Business Name): ALFRED LEWIS HURWITZ M D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/25/2006
Last Update Date: 07/06/2022
Certification Date: 07/06/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15899 LOS GATOS ALMADEN RD STE 11
LOS GATOS CA
95032-3739
US
IV. Provider business mailing address
15899 LOS GATOS ALMADEN RD STE 11
LOS GATOS CA
95032-3739
US
V. Phone/Fax
- Phone: 408-294-4272
- Fax: 408-294-1279
- Phone: 408-294-4272
- Fax: 408-294-1279
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | G20286 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: