Organization
COUNTY OF SANTA CLARA
Active
Other names
SCVMC Ambulatory Surgery Unit
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFONSO F BANUELOS JR. MD (CHIEF MEDICAL OFFICER)
(408) 885-4001
Entity
Organization
Contact information
Practice address
751 S BASCOM AVE, SCVMC AMBULATORY SURGERY UNIT, SAN JOSE, CA 95128-2604
(408) 885-5000
Mailing address
PO BOX 5280, PATIENT BUSINESS SERVICES, SAN JOSE, CA 95150-5280
(408) 885-7200
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
HSP40038F
—
CA
Enumeration date
11/06/2006
Last updated
08/22/2020
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