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General NPI Number Information
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NPI Number | 1821079757
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Entity Type | Individual
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Provider Name | LEWIS A OSOFSKY M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 500 EL CAMINO REAL BUILDING 701
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City | SANTA CLARA
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State | CA
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Zip | 95053-1055
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Country | US
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Telephone | 408-554-4501
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Fax | 408-554-2376
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Provider Business Mailing Address
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Address Line | 500 EL CAMINO REAL BLDG 701
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City | SANTA CLARA
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State | CA
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Zip | 95053-1055
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Country | US
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Telephone | 408-554-4501
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Fax | 408-554-2376
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G47908
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License Number State | CA
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