Healthcare Provider Details

I. General information

NPI: 1255919775
Provider Name (Legal Business Name): YEMA NADEM JALAL
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2021
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 MOWRY AVE STE 201
FREMONT CA
94538-1730
US

IV. Provider business mailing address

1860 MOWRY AVE STE 201
FREMONT CA
94538-1730
US

V. Phone/Fax

Practice location:
  • Phone: 925-685-4224
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number20829
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: