Organization
COUNTY OF SANTA CLARA
Active
Parent organization
COUNTY OF SANTA CLARA
Other names
SCVMC Physician Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SANTA CLARA
Authorized official
DR. ALFONSO F BANUELOS JR. MD (CHIEF MEDICAL OFFICER)
40888550000
Entity
Organization
Contact information
Practice address
751 S BASCOM AVE, PHYSICIAN SERVICES, SAN JOSE, CA 95128-2604
(408) 885-5000
Mailing address
PO BOX 5730, PATIENT BUSINESS SERVICES, SAN JOSE, CA 95150-5730
(408) 885-7200
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0076270
—
CA
05
—
GR0076271
—
CA
05
—
GR0076272
—
CA
Enumeration date
10/05/2007
Last updated
10/05/2007
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