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General NPI Number Information
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NPI Number | 1487808614
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Entity Type | Organization
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Legal Business Name | COUNTY OF SANTA CLARA
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Dates
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Enumeration Date | 11/14/2008
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Last Update Date | 11/14/2008
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Provider Practice Location Address
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Address Line | 751 S BASCOM AVE
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City | SAN JOSE
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State | CA
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Zip | 95128-2604
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Country | US
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Telephone | 408-885-5000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5730
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City | SAN JOSE
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State | CA
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Zip | 95150-5730
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Country | US
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Telephone | 408-885-7200
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DR. ALFONSO F BANUELOS JR.
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Credential | MD
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Telephone | 408-885-4001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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