Organization
SAN JOSE SURGICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SCOTT BENNINGHOVEN MD (OWNER)
(408) 848-3799
Entity
Organization
Contact information
Practice address
150 N JACKSON AVE, SUITE 100, SAN JOSE, CA 95116-1908
(408) 770-2297
(408) 770-2649
Mailing address
PO BOX 681, LOS ALTOS, CA 94023-0681
(408) 770-2297
(408) 770-2649
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
10/06/2014
Last updated
05/09/2016
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