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General NPI Number Information
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NPI Number | 1003825175
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Entity Type | Organization
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Legal Business Name | MEHRNAZ JAMALI MD INC
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Dates
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Enumeration Date | 08/06/2006
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Last Update Date | 09/01/2021
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Provider Practice Location Address
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Address Line | 5000 PLEASANTON AVE STE 110
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City | PLEASANTON
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State | CA
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Zip | 94566-7052
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Country | US
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Telephone | 925-484-4406
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Fax | 925-484-0346
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Provider Business Mailing Address
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Address Line | 5000 PLEASANTON AVE STE 110
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City | PLEASANTON
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State | CA
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Zip | 94566-7052
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Country | US
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Telephone | 858-335-3310
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Fax | 949-831-0339
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Authorized Official
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Title or Position | CFO
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Name | MARJAN LOGHGMAN
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Credential |
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Telephone | 858-335-3110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | A53933
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License Number State | CA
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