NPIMap

Organization Active NPI

County of Santa Clara

  • Allergy Physician
  • San Jose, CA
National Provider Identifier
1104014935
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
Legal business name
COUNTY OF SANTA CLARA
Practice address
751 S Bascom Ave
Physician Services
San Jose, CA 95128-2604
Phone
(408) 885-5000
NPI assigned
Oct 5, 2007
Organization subpart
Yes
Parent organization
COUNTY OF SANTA CLARAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Alfonso F Banuelos Jr., MD
Title
Chief Medical Officer
Phone
40888550000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207KA0200X Primary

Addresses

Primary practice location

751 S Bascom Ave
Physician Services
San Jose, CA 95128-2604

Mailing address

PO Box 5730
Patient Business Services
San Jose, CA 95150-5730
Phone (408) 885-7200

Other identifiers 3

IdentifierTypeStateIssuer
GR0076271MedicaidCA
GR0076270MedicaidCA
GR0076272MedicaidCA

Other names 1

  • SCVMC Physician Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Professional Group VMC3 organizations share this tax ID, including this one
Part of
Scvhhsaep

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 20

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1104014935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5730",
            "address_2": "PATIENT BUSINESS SERVICES",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951505730",
            "telephone_number": "408-885-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 S BASCOM AVE",
            "address_2": "PHYSICIAN SERVICES",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282604",
            "telephone_number": "408-885-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF SANTA CLARA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNTY OF SANTA CLARA",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "BANUELOS",
        "authorized_official_first_name": "ALFONSO",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "40888550000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0076271",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0076270",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0076272",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SCVMC Physician Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.