Organization
COUNTY OF SANTA CLARA VHC TB CLINIC-LENZEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALFONSO BANUELOS M.D. (CHIEF MEDICAL OFFICER)
(408) 885-4010
Entity
Organization
Contact information
Practice address
976 LENZEN AVE, SAN JOSE, CA 95126-2737
(408) 792-5596
(408) 947-8778
Mailing address
1262 OAKGLEN WAY, SAN JOSE, CA 95120-2733
(408) 323-1279
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
432283
CA
Other
Enumeration date
08/02/2005
Last updated
08/22/2020
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