Healthcare Provider Details

I. General information

NPI: 1679891758
Provider Name (Legal Business Name): JAY ROBERT CATENA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2010
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

513 PARNASSUS AVE RM S-358 BOX 0628, SLOT 28 STONE LIBRARY
SAN FRANCISCO CA
94143-2205
US

IV. Provider business mailing address

20661 MARION RD
SARATOGA CA
95070-5817
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-1575
  • Fax:
Mailing address:
  • Phone: 210-387-3008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA111026
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: