Provider Demographics
NPI:1548295868
Name:CONTRERAS, JORGE V (MD)
Entity type:Individual
Prefix:
First Name:JORGE
Middle Name:V
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:841 BLOSSOM HILL RD
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-2704
Mailing Address - Country:US
Mailing Address - Phone:408-629-7095
Mailing Address - Fax:408-281-8235
Practice Address - Street 1:841 BLOSSOM HILL RD
Practice Address - Street 2:SUITE 215
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95123-2704
Practice Address - Country:US
Practice Address - Phone:408-629-7095
Practice Address - Fax:408-281-8235
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2008-03-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG45510207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G455100Medicare PIN
CAA50071Medicare UPIN