Healthcare Provider Details

I. General information

NPI: 1497700322
Provider Name (Legal Business Name): CFL CHILDREN'S MEDICAL ASSOCIATES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 FOREST AVE SUITE 304
SAN JOSE CA
95128-4817
US

IV. Provider business mailing address

2039 FOREST AVE SUITE 304
SAN JOSE CA
95128-4817
US

V. Phone/Fax

Practice location:
  • Phone: 408-297-5959
  • Fax: 408-297-5970
Mailing address:
  • Phone: 408-297-5959
  • Fax: 408-297-5970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA45172
License Number StateCA

VIII. Authorized Official

Name: DR. NARCISO THAD PADUA
Title or Position: PRESIDENT
Credential: M.D.
Phone: 408-947-2697