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General NPI Number Information
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NPI Number | 1477573285
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Entity Type | Organization
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Legal Business Name | CENTER FOR PAIN & REHABILITATION MEDICINE
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 3097 MOORPARK AVE STE 200
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City | SAN JOSE
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State | CA
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Zip | 95128-2543
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Country | US
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Telephone | 408-244-7246
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Fax | 408-244-7248
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Provider Business Mailing Address
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Address Line | 3097 MOORPARK AVE STE 200
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City | SAN JOSE
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State | CA
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Zip | 95128-2543
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Country | US
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Telephone | 408-244-7246
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Fax | 408-244-7248
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. MICHAEL M JADALI
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Credential | DO
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Telephone | 408-244-7246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2081P0301X
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Taxonomy Name | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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