Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
ETHAN JOSE, MD
ActiveETHAN JOSE, MD is a Sports Medicine healthcare provider located in SANTA CRUZ, California. NPI 1427673623 is currently active in the NPPES registry. Verify at CMS.
Sports Medicine · SANTA CRUZ, CA
Registration Details
- NPI Number
- 1427673623
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 12, 2020 (6.2156648124662 yrs)
- Last Updated
- Aug 15, 2024
- License
-
A194810 (CA)
Practice Information
- Address
-
110 COOPER ST # 500SANTA CRUZ, CA, 950604574Browse CA providers · Browse ZIP 95060
- Phone
- 8314254100
- Primary Specialty
-
Sports Medicine
207QS0010X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.