Healthcare Provider Details

I. General information

NPI: 1790014835
Provider Name (Legal Business Name): JEFFERY ELWOOD HESS M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2009
Last Update Date: 09/12/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 BORDEAUX DR BLDG 3
SUNNYVALE CA
94089-1209
US

IV. Provider business mailing address

1387 PIERCE ST
BIRMINGHAM MI
48009-3648
US

V. Phone/Fax

Practice location:
  • Phone: 513-939-8491
  • Fax:
Mailing address:
  • Phone: 513-939-8491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number35.064406
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberG198919
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number4301104124
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: