Provider Demographics
NPI:1568730539
Name:BOS GURKO, ELSJE E
Entity Type:Individual
Prefix:
First Name:ELSJE
Middle Name:E
Last Name:BOS GURKO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3031 TISCH WAY
Mailing Address - Street 2:SUITE 306
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-2541
Mailing Address - Country:US
Mailing Address - Phone:408-857-1122
Mailing Address - Fax:408-554-4209
Practice Address - Street 1:3031 TISCH WAY
Practice Address - Street 2:SUITE 306
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-2541
Practice Address - Country:US
Practice Address - Phone:408-857-1122
Practice Address - Fax:408-554-4209
Is Sole Proprietor?:No
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other