Healthcare Provider Details

I. General information

NPI: 1497968523
Provider Name (Legal Business Name): JAYWANT P PARMAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2320 BATH STREET , SUITE 113
SANTA BARBAR CA
93105-5322
US

IV. Provider business mailing address

DEPT LA 21613
PASADENA CA
91185-1613
US

V. Phone/Fax

Practice location:
  • Phone: 805-682-7744
  • Fax: 805-682-3321
Mailing address:
  • Phone: 949-263-8620
  • Fax: 800-409-7005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberA80323
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: