Healthcare Provider Details

I. General information

NPI: 1679482970
Provider Name (Legal Business Name): FIEL JR BUENCAMINO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 MOORPARK AVE
SAN JOSE CA
95117-4103
US

IV. Provider business mailing address

821 MORAGA DR
MOUNTAIN VIEW CA
94041-2586
US

V. Phone/Fax

Practice location:
  • Phone: 341-208-9531
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number37647
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: