Organization
SAN JOSE HEALTH CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSE M PISCOYA M.D. (PRESIDENT)
(928) 722-6098
Entity
Organization
Contact information
Practice address
1962 E JUAN SANCHEZ BLVD, STE 1, SAN LUIS, AZ 85349
(928) 722-6098
(928) 627-0007
Mailing address
PO BOX 1689, SAN LUIS, AZ 85349-1689
(928) 722-6098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25569
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
838352
—
AZ
Enumeration date
03/03/2008
Last updated
03/03/2008
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