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1730130105

NPI Code Detail

MEDICARE: SANJAY KUMAR JAIN MD

MEDICARE: SANJAY KUMAR JAIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	D60342	MD
2	2085R0202X	Diagnostic Radiology Physician	ME101362	FL
3	2085R0202X	Diagnostic Radiology Physician	A65344	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730130105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANJAY KUMAR JAIN MD

Provider Business Mailing Address
First Line	:	FILE 57326
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90074-0001
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 W ARBOR DR
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92103-9000
Country	:	US
Telephone Number	:	800-926-8273
Fax Number	:	888-539-8781

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	06/02/2026

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Directions to “ SANJAY KUMAR JAIN MD” Practice Location

Language	Start Address	Practice Location

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