Organization
GENESIS CLINICA DE LA MUJER INC
Active
Other names
Genesis Clinica de la Mujer
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROSA ELENA HEREDIA MSN (PRESIDENT)
(408) 258-3724
Entity
Organization
Contact information
Practice address
244 N JACKSON AVE, SUITE 209, SAN JOSE, CA 95116-1604
(408) 258-3724
(408) 258-3736
Mailing address
244 N JACKSON AVE, SUITE 209, SAN JOSE, CA 95116-1604
(408) 258-3724
(408) 258-3736
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
G75190
CA
207V00000X
Obstetrics & Gynecology Physician
Primary
G81814
CA
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
NP9507
CA
Other
Enumeration date
03/09/2010
Last updated
11/14/2011
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