Individual
JUAN CARLOS TUD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CLS, CCP
Contact information
Practice address
250 FERNANDO AVE, PALO ALTO, CA 94306-2814
(515) 865-5471
Mailing address
250 FERNANDO AVE, PALO ALTO, CA 94306-2814
(515) 865-5471
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
999074
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
999074
AMERICAN BOARD OF CARDIOVASCULAR PERFUSION
—
Enumeration date
11/04/2018
Last updated
11/04/2018
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