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General NPI Number Information
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NPI Number | 1891723375
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Entity Type | Individual
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Provider Name | MICHAEL M JADALI D.O. , RPH
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Gender | Male
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Dates
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Enumeration Date | 06/30/2006
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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 |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 20A9504
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License Number State | CA
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Taxonomy #2
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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 | 20A9504
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License Number State | CA
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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 | 20A9504
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | 20A9504
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 204D00000X
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Taxonomy Name | Neuromusculoskeletal Medicine & OMM Physician
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License Number | 20A9504
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License Number State | CA
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