Provider First Line Business Practice Location Address:
250 HOSPITAL PKWY
Provider Second Line Business Practice Location Address:
PT DEPT.
Provider Business Practice Location Address City Name:
SAN JOSE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95119-1103
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-972-7238
Provider Business Practice Location Address Fax Number:
408-972-7548
Provider Enumeration Date:
11/30/2006