MEDICARE: DAVID HENSLEY 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	2084P0800X	Psychiatry Physician	A74318	CA

General Provider Information

NPI Number	:	1548232911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID HENSLEY M.D.

Provider Business Mailing Address
First Line	:	5755 COTTLE RD
Second Line	:	BUILDING 4
City	:	SAN JOSE
State	:	CA
Zip	:	95123-3640
Country	:	US
Telephone Number	:	408-972-3095
Fax Number	:

Provider Business Practice Location Address
First Line	:	5755 COTTLE RD
Second Line	:	BUILDING 4
City	:	SAN JOSE
State	:	CA
Zip	:	95123-3640
Country	:	US
Telephone Number	:	408-972-3095
Fax Number	:

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	12/09/2021

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