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General NPI Number Information
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NPI Number | 1780940536
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Entity Type | Individual
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Provider Name | ALAN NMI JARACH MD
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Gender | Male
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 83 SUNNY OAKS DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3084
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Country | US
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Telephone | 415-479-5132
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Fax | 415-000-0000
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Provider Business Mailing Address
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Address Line | 83 SUNNY OAKS DR
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City | SAN RAFAEL
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State | CA
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Zip | 94903-3084
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Country | US
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Telephone | 415-479-5132
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Fax | 415-000-0000
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | G11450
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License Number State | CA
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