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570 Blossom Hill Rd San Jose CA 95123-3212 | |
| (855) 799-4647 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 570 Blossom Hill Rd, San Jose, California |
| Authorized Official Name and Position | Andrew Serry Dumbuya (CEO) |
| Authorized Official Contact | 4084012984 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
570 Blossom Hill Rd San Jose CA 95123-3212 Ph: (855) 799-4647 | 570 Blossom Hill Rd San Jose CA 95123-3212 Ph: (855) 799-4647 |
| NPI Number | 1760969539 |
|---|---|
| Provider Enumeration Date | 07/25/2018 |
| Last Update Date | 10/22/2021 |
| Certification Date | 10/22/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760969539 | NPI | - | NPPES |
| CA336219 | Other | CA | CA MEDICARE |
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