Individual
DR. ALFONSO F BANUELOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 S BASCOM AVE, HOSPITAL ADMINISTRATION, SAN JOSE, CA 95128-2604
(408) 885-4001
Mailing address
751 S BASCOM AVE, HOSPITAL ADMINISTRATION, SAN JOSE, CA 95128-2604
(408) 885-4001
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
G45949
CA
207R00000X
Internal Medicine Physician
Primary
G45949
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G459490
—
CA
Enumeration date
09/12/2005
Last updated
09/13/2007
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