=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053334698
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALFRED LEWIS HURWITZ M D
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2006
-----------------------------------------------------
Last Update Date | 07/06/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15899 LOS GATOS ALMADEN RD STE 11
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95032-3739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-294-4272
-----------------------------------------------------
Fax | 408-294-1279
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15899 LOS GATOS ALMADEN RD STE 11
-----------------------------------------------------
City | LOS GATOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95032-3739
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-294-4272
-----------------------------------------------------
Fax | 408-294-1279
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | G20286
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------