Healthcare Provider Details

I. General information

NPI: 1376860395
Provider Name (Legal Business Name): EMANUEL ALBARAN ELIAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2010
Last Update Date: 08/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2734 EL CAMINO REAL
SANTA CLARA CA
95051-3041
US

IV. Provider business mailing address

2350 W. EL CAMINO REAL 2ND FLOOR
MOUNTAIN VIEW CA
94040-6203
US

V. Phone/Fax

Practice location:
  • Phone: 408-739-6000
  • Fax:
Mailing address:
  • Phone: 408-241-3801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA120139
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: