Healthcare Provider Details

I. General information

NPI: 1851590780
Provider Name (Legal Business Name): JUAN E POSADA MD INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 06/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 JOSE FIGUERES AVE STE #485-495
SAN JOSE CA
95116-1585
US

IV. Provider business mailing address

200 JOSE FIGUERES AVE STE #485-495
SAN JOSE CA
95116-1585
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-3022
  • Fax: 408-259-3040
Mailing address:
  • Phone: 408-259-3022
  • Fax: 408-259-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA54533
License Number StateCA

VIII. Authorized Official

Name: DR. JUAN ESTEBAN POSADA
Title or Position: M.D
Credential: M.D
Phone: 408-259-3022