Healthcare Provider Details

I. General information

NPI: 1285758912
Provider Name (Legal Business Name): ALVIN ORILLANEDA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 02/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2665 ORINDA DR
SAN JOSE CA
95121-1233
US

IV. Provider business mailing address

2655 ORINDA DR
SAN JOSE CA
95121
US

V. Phone/Fax

Practice location:
  • Phone: 408-607-5087
  • Fax:
Mailing address:
  • Phone: 408-607-5087
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number05007957A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: