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General NPI Number Information
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NPI Number | 1902086341
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Entity Type | Organization
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Legal Business Name | VIJAY THUKRAL, MD, A PROFESSIONAL CORP.
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Dates
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Enumeration Date | 11/13/2007
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Last Update Date | 08/26/2009
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Provider Practice Location Address
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Address Line | 995 MONTAGUE EXPY SUITE #213
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City | MILPITAS
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State | CA
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Zip | 95035-6851
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Country | US
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Telephone | 408-258-7400
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Fax | 408-258-2175
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Provider Business Mailing Address
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Address Line | 995 MONTAGUE EXPY SUITE #213
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City | MILPITAS
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State | CA
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Zip | 95035-6851
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Country | US
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Telephone | 408-258-7400
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Fax | 408-258-2175
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Authorized Official
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Title or Position | CEO
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Name | DR. VIJAY K. THUKRAL
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Credential | M.D.
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Telephone | 408-258-7400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 00A423070
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License Number State | CA
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