Organization
PETER BADUA PAC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES DAMON FRACH PHD (OFFICE MANAGER)
(408) 984-2455
Entity
Organization
Contact information
Practice address
53 CRONIN DR, SANTA CLARA, CA 95051-6719
(408) 984-2455
(408) 984-2456
Mailing address
53 CRONIN DR, SANTA CLARA, CA 95051-6719
(408) 984-2455
(408) 984-2456
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Enumeration date
12/18/2010
Last updated
12/18/2010
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