Provider Demographics
NPI:1215034988
Name:SAN JOSE PULMONARY ASSOCIATES
Entity Type:Organization
Organization Name:SAN JOSE PULMONARY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:BURBANO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:408-258-5864
Mailing Address - Street 1:2112 MCKEE RD # B
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1427
Mailing Address - Country:US
Mailing Address - Phone:408-258-5864
Mailing Address - Fax:408-272-5864
Practice Address - Street 1:2112 MCKEE RD # B
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1427
Practice Address - Country:US
Practice Address - Phone:408-258-5864
Practice Address - Fax:408-272-5864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-17
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ84139ZMedicare ID - Type Unspecified