Healthcare Provider Details

I. General information

NPI: 1346443199
Provider Name (Legal Business Name): MR. GILBERT S. TOBIAS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2269 WARFIELD WAY UNIT C
SAN JOSE CA
95122-3657
US

IV. Provider business mailing address

2269 WARFIELD WAY UNIT C
SAN JOSE CA
95122-3657
US

V. Phone/Fax

Practice location:
  • Phone: 408-294-9280
  • Fax: 408-294-9280
Mailing address:
  • Phone: 408-294-9280
  • Fax: 408-294-9280

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number2005969307
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: