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Organization
LUMOS ADVANCED TREATMENT CENTER LLC
Active
Organization
LUMOS ADVANCED TREATMENT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIDWATH KASHYAP ESQ (BUSINESS DIRECTOR)
(415) 741-6103
Entity
Organization
Contact information
Practice address
2516 SAMARITAN DR STE D, SAN JOSE, CA 95124-4108
(408) 539-7715
(408) 402-5116
Mailing address
2516 SAMARITAN DR STE D, SAN JOSE, CA 95124-4108
(415) 741-6103
(408) 402-5116
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
01/19/2024
Last updated
01/19/2024
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