Healthcare Provider Details
I. General information
NPI: 1972560381
Provider Name (Legal Business Name): JIVA HEALTH PRIMARY CARE
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/28/2006
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2182 EAST ST
CONCORD CA
94520-2012
US
IV. Provider business mailing address
2182 EAST ST
CONCORD CA
94520-2012
US
V. Phone/Fax
- Phone: 925-685-4224
- Fax: 925-685-6997
- Phone: 310-903-9727
- Fax: 925-685-6997
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
IMRAN
JUNAID
Title or Position: PRESIDENT/OWNER/PHYSICIAN
Credential: MD
Phone: 310-903-9727