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NPI Code Detail

MEDICARE: DR. JACK YUNGZEN JENG MD

MEDICARE: DR. JACK YUNGZEN JENG MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207L00000XAnesthesiology PhysicianA148416CA

General Provider Information

NPI Number : 1174917207
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JACK YUNGZEN JENG MD
Provider Business Mailing Address
First Line : 1800 HARRISON ST FL 7
Second Line :
City : OAKLAND
State : CA
Zip : 94612-3466
Country : US
Telephone Number : 480-710-7756
Fax Number :
Provider Business Practice Location Address
First Line : 1200 EL CAMINO REAL
Second Line :
City : SOUTH SAN FRANCISCO
State : CA
Zip : 94080-3299
Country : US
Telephone Number : 480-710-7756
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/26/2015
Last Update Date : 08/11/2023

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