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General NPI Number Information
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NPI Number | 1336238542
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Entity Type | Organization
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Legal Business Name | H. MICHAEL JAFFIN, M. D., INC
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 02/13/2009
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Provider Practice Location Address
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Address Line | 3720 SUNSET LANE SUITE #A
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City | ANTIOCH
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State | CA
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Zip | 94509-6124
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Country | US
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Telephone | 925-706-7788
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Fax | 925-706-7988
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Provider Business Mailing Address
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Address Line | 3720 SUNSET LANE SUITE #A
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City | ANTIOCH
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State | CA
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Zip | 94509-6124
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Country | US
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Telephone | 925-706-7788
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Fax | 925-706-7988
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. AVONA R. LAUDENSLAYER
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Credential |
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Telephone | 925-706-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G30854
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License Number State | CA
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