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General NPI Number Information
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NPI Number | 1568767663
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Entity Type | Organization
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Legal Business Name | D. THOMAS URBAN M.D., INC
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Dates
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Enumeration Date | 01/20/2011
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Last Update Date | 01/20/2011
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Provider Practice Location Address
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Address Line | 6501 CROWN BLVD. SUITE #106A
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City | SAN JOSE
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State | CA
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Zip | 95120-2903
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Country | US
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Telephone | 408-268-9660
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Fax | 408-268-9662
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Provider Business Mailing Address
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Address Line | 6501 CROWN BLVD. SUITE #106A
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City | SAN JOSE
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State | CA
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Zip | 95120-2903
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Country | US
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Telephone | 408-268-9660
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Fax | 408-268-9662
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Authorized Official
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Title or Position | PRESIDNET/ OWNER
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Name | DR. DOLPH THOMAS URBAN
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Credential | M.D.
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Telephone | 408-268-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 00A202480
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License Number State | CA
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