Healthcare Provider Details

I. General information

NPI: 1376637199
Provider Name (Legal Business Name): BABAK JAHROMI JAMASBI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ROBERT JAHROMI JAMASBI M.D.

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1335 STANFORD AVE
EMERYVILLE CA
94608-1115
US

IV. Provider business mailing address

1335 STANFORD AVE
EMERYVILLE CA
94608-2536
US

V. Phone/Fax

Practice location:
  • Phone: 510-649-7000
  • Fax: 510-740-7769
Mailing address:
  • Phone: 510-649-7000
  • Fax: 510-740-7769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG70042
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberG70042
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberG70042
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License NumberG70042
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: