Healthcare Provider Details

I. General information

NPI: 1336097708
Provider Name (Legal Business Name): MOHAMMAD JARRAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2026
Last Update Date: 03/20/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13278 TECUMSEH RD EAST 204
TECUMSEH ONTARIO
N8N 3TX
CA

IV. Provider business mailing address

13278 TECUMSEH RD EAST 204
TECUMSEH ONTARIO
N8N 3TX
CA

V. Phone/Fax

Practice location:
  • Phone:
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0207X
TaxonomyPediatric Hematology & Oncology Physician
License Number4301106602
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: