Healthcare Provider Details

I. General information

NPI: 1558324582
Provider Name (Legal Business Name): KIREN SAVITA JAIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KIREN SAVITA MEHRA MD

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 01/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 WHIPPLE AVENUE SUITE 100
REDWOOD CITY CA
94062
US

IV. Provider business mailing address

PO BOX 742244
LOS ANGELES CA
90074-2244
US

V. Phone/Fax

Practice location:
  • Phone: 650-261-2303
  • Fax: 650-261-2301
Mailing address:
  • Phone: 408-984-7226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberMD00039747
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG88160
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: