MEDICARE: DR. DAVID JUAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	G078505	CA

General Provider Information

NPI Number	:	1205877222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID JUAN M.D.

Provider Business Mailing Address
First Line	:	3466 EL CAMINO REAL
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-2809
Country	:	US
Telephone Number	:	408-554-1400
Fax Number	:	408-554-1500

Provider Business Practice Location Address
First Line	:	3466 EL CAMINO REAL
Second Line	:
City	:	SANTA CLARA
State	:	CA
Zip	:	95051-2809
Country	:	US
Telephone Number	:	408-554-1400
Fax Number	:	408-554-1500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/24/2007

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