=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740306703
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JAY GARFINKLE, M.D. A PROFESSIONAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/22/2007
-----------------------------------------------------
Last Update Date | 03/18/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 27225 CALAROGA AVE
-----------------------------------------------------
City | HAYWARD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94545-4338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-780-9148
-----------------------------------------------------
Fax | 510-780-9149
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27225 CALAROGA AVE
-----------------------------------------------------
City | HAYWARD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94545-4338
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-780-9148
-----------------------------------------------------
Fax | 510-780-9149
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | M JAY GARFINKLE
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 510-780-9148
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208600000X
-----------------------------------------------------
Taxonomy Name | Surgery Physician
-----------------------------------------------------
License Number | G22474
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------