Healthcare Provider Details

I. General information

NPI: 1700012770
Provider Name (Legal Business Name): JED A KATZEL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2009
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 LAWRENCE EXPY ONCOLOGY DEPARTMENT #440
SANTA CLARA CA
95051-5173
US

IV. Provider business mailing address

710 LAWRENCE EXPY ONCOLOGY DEPARTMENT #440
SANTA CLARA CA
95051-5173
US

V. Phone/Fax

Practice location:
  • Phone: 408-851-4323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA109319
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD.MD.70121967
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberDR.0077390
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number237353
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: