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Organization
MIRA MACE MEDICAL SERVICES WEST PC
Active
Organization
MIRA MACE MEDICAL SERVICES WEST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PRASHANT KUMAR (OPERATIONS ADMINISTRATOR)
(332) 296-0021
Entity
Organization
Contact information
Practice address
2445 AUGUSTINE DR, SANTA CLARA, CA 95054-3032
(332) 296-0021
Mailing address
1111B S GOVERNORS AVE STE 39475, DOVER, DE 19904-6903
(332) 296-0021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/10/2025
Last updated
06/03/2026
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