Graduated: 1996
NPI: 1003911124
Practice Locations (2)
COUNTY OF SANTA CLARA
751 S BASCOM AVE
SAN JOSE, CA 951282604
4088855000
COUNTY OF SANTA CLARA
751 S BASCOM AVE, SANTA CLARA VLY MED
SAN JOSE, CA 951282604
4088855000
Source: CMS National Downloadable File, September 2026.