Provider Demographics
NPI:1801998836
Name:ENZ, JOSE (MD)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:ENZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:500 ALFRED NOBEL DR
Mailing Address - Street 2:#255A
Mailing Address - City:HERCULES
Mailing Address - State:CA
Mailing Address - Zip Code:94547-1838
Mailing Address - Country:US
Mailing Address - Phone:510-964-9647
Mailing Address - Fax:510-964-9656
Practice Address - Street 1:500 ALFRED NOBEL DR
Practice Address - Street 2:#255A
Practice Address - City:HERCULES
Practice Address - State:CA
Practice Address - Zip Code:94547-1838
Practice Address - Country:US
Practice Address - Phone:510-964-9647
Practice Address - Fax:510-964-9656
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2015-04-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG051091208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics