Healthcare Provider Details

I. General information

NPI: 1730512070
Provider Name (Legal Business Name): JEFFREY T HOLMES MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2013
Last Update Date: 08/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W PARR AVE SUITE E
LOS GATOS CA
95032-1442
US

IV. Provider business mailing address

700 W PARR AVE SUITE E
LOS GATOS CA
95032-1416
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-4959
  • Fax: 408-358-8692
Mailing address:
  • Phone: 408-356-4959
  • Fax: 408-358-8692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberG48778
License Number StateCA

VIII. Authorized Official

Name: DR. JEFFREY T HOLMES
Title or Position: PROVIDER OWNER
Credential: M.D.
Phone: 408-356-4959