Healthcare Provider Details

I. General information

NPI: 1346135407
Provider Name (Legal Business Name): JAD BELLE MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2025
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 BROADWAY ST FL C2
REDWOOD CITY CA
94063-3132
US

IV. Provider business mailing address

450 BROADWAY ST FL C2
REDWOOD CITY CA
94063-3132
US

V. Phone/Fax

Practice location:
  • Phone: 650-721-7190
  • Fax: 650-721-3464
Mailing address:
  • Phone: 650-721-7190
  • Fax: 650-721-3464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number21420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: