Provider Demographics
NPI:1053334698
Name:HURWITZ, ALFRED LEWIS (M D)
Entity Type:Individual
Prefix:DR
First Name:ALFRED
Middle Name:LEWIS
Last Name:HURWITZ
Suffix:
Gender:M
Credentials:M D
Other - Prefix:DR
Other - First Name:ALFRED
Other - Middle Name:LEWIS
Other - Last Name:HURWITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:15899 LOS GATOS ALMADEN RD STE 11
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-3739
Mailing Address - Country:US
Mailing Address - Phone:408-294-4272
Mailing Address - Fax:408-294-1279
Practice Address - Street 1:15899 LOS GATOS ALMADEN RD STE 11
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-3739
Practice Address - Country:US
Practice Address - Phone:408-294-4272
Practice Address - Fax:408-294-1279
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG20286174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G202860Medicaid
CA00G202860Medicare ID - Type Unspecified
CAA89325Medicare UPIN