Healthcare Provider Details

I. General information

NPI: 1164880761
Provider Name (Legal Business Name): EL CAMINO HEALTH MEDICAL NETWORK, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2016
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

828 S WINCHESTER BLVD
SAN JOSE CA
95128-2930
US

IV. Provider business mailing address

973 UNIVERSITY AVE
LOS GATOS CA
95032-7636
US

V. Phone/Fax

Practice location:
  • Phone: 408-871-3400
  • Fax: 408-866-3999
Mailing address:
  • Phone: 408-871-3200
  • Fax: 650-448-1431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ALAN MUSTER
Title or Position: PRESIDENT
Credential: MD
Phone: 408-871-3200