Healthcare Provider Details

I. General information

NPI: 1275755472
Provider Name (Legal Business Name): ALEJANDRO MAGANA P.A., D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/04/2021
Certification Date: 08/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2520 SAMARITAN DR STE 104B
SAN JOSE CA
95124-4106
US

IV. Provider business mailing address

2520 SAMARITAN DR STE 104B
SAN JOSE CA
95124-4106
US

V. Phone/Fax

Practice location:
  • Phone: 408-356-8400
  • Fax: 855-834-6677
Mailing address:
  • Phone: 408-356-8400
  • Fax: 855-834-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA22114
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number30450
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: