Healthcare Provider Details

I. General information

NPI: 1356504476
Provider Name (Legal Business Name): JENNY F JEW M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNY F LAI M.D.

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2222 EAST ST STE 300
CONCORD CA
94520-2066
US

IV. Provider business mailing address

3903 LONE TREE WAY STE 205
ANTIOCH CA
94509-6249
US

V. Phone/Fax

Practice location:
  • Phone: 925-682-7730
  • Fax:
Mailing address:
  • Phone: 925-754-8710
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberA110315
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: