=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679150270
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAI HO TV INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/28/2021
-----------------------------------------------------
Last Update Date | 03/28/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 39180 LIBERTY ST
-----------------------------------------------------
City | FREMONT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94538-1512
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 669-264-7522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 16800 MONTEREY RD UNIT 200
-----------------------------------------------------
City | MORGAN HILL
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95037-9756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 669-264-7522
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DIRECTOR
-----------------------------------------------------
Name | SRINIVAS THIRUNAGARI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 669-264-7522
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QA0600X
-----------------------------------------------------
Taxonomy Name | Adult Day Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------