# SAN JOSE HEALTH CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770753162
- **Authorized official:** DR. JOSE M PISCOYA M.D. (PRESIDENT)
- **Authorized official phone:** (928) 722-6098

## Contact information

- **Practice address:** 1962 E JUAN SANCHEZ BLVD, STE 1, SAN LUIS, AZ 85349
- **Practice address phone:** (928) 722-6098
- **Practice address fax:** (928) 627-0007
- **Mailing address:** PO BOX 1689, SAN LUIS, AZ 85349-1689
- **Mailing address phone:** (928) 722-6098

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 25569 | AZ | Yes |

## Other

- **Enumeration date:** 03/03/2008
- **Last updated:** 03/03/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 838352 | — | AZ |