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General NPI Number Information
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NPI Number | 1760431571
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Entity Type | Organization
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Legal Business Name | A R JAYARAM MD A PROFESSIONAL CORP
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 04/02/2015
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Provider Practice Location Address
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Address Line | 1250 CONCANNON BLVD
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City | LIVERMORE
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State | CA
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Zip | 94550-6002
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Country | US
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Telephone | 925-455-4120
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Fax | 925-455-5020
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Provider Business Mailing Address
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Address Line | 1250 CONCANNON BLVD
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City | LIVERMORE
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State | CA
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Zip | 94550-6002
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Country | US
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Telephone | 925-455-4120
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Fax | 925-455-5020
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ATTIGUPAM R JAYARAM
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Credential | M.D.
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Telephone | 925-455-4120
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20A7585
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A25987
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License Number State | CA
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