Healthcare Provider Details

I. General information

NPI: 1902839053
Provider Name (Legal Business Name): DAGMAR MARIA HORVATH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 05/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SAMARITAN DR SUITE A
SAN JOSE CA
95124-4104
US

IV. Provider business mailing address

2550 SAMARITAN DR SUITE A
SAN JOSE CA
95124-4104
US

V. Phone/Fax

Practice location:
  • Phone: 408-295-8988
  • Fax: 408-295-8731
Mailing address:
  • Phone: 408-295-8988
  • Fax: 408-295-8731

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberA25261
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: