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General NPI Number Information
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NPI Number | 1891915005
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Entity Type | Organization
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Legal Business Name | OSTEOPOROSIS CENTER OF SAN JOSE
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 09/16/2008
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Provider Practice Location Address
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Address Line | 25 N 14TH ST STE 890
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City | SAN JOSE
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State | CA
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Zip | 95112-6216
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Country | US
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Telephone | 408-288-6694
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Fax | 408-288-6698
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Provider Business Mailing Address
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Address Line | 25 N. 14TH ST. SUITE 890
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City | SAN JOSE
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State | CA
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Zip | 95112
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Country | US
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Telephone | 408-288-6694
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Fax | 408-288-6698
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. BRUCE J DREYFUSS
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Credential | MD
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Telephone | 408-288-6694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | FAC52131
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2471B0102X
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Taxonomy Name | Bone Densitometry Radiologic Technologist
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License Number | RHC142268
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License Number State | CA
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