Individual
JACQUELINE FR LOU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
(510) 859-4717
Mailing address
751 S BASCOM AVE, SAN JOSE, CA 95128-2604
(510) 859-4717
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
A138292
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/02/2014
Last updated
04/26/2019
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