Individual
MR. ALEC JONATHAN BURCKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
160 E VIRGINIA ST STE 100, SAN JOSE, CA 95112-5865
(408) 938-2113
(408) 579-6143
Mailing address
5300 TERNER WAY APT 1121, SAN JOSE, CA 95136-4130
(661) 874-7777
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/24/2020
Last updated
08/24/2020
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