MEDICARE: CENTER FOR PAIN & REHABILITATION MEDICINE

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	2081N0008X	Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
2	2081P0301X	Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician
3	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician
4	261QM2500X	Medical Specialty Clinic/Center
5	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician

General Provider Information

NPI Number	:	1477573285
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER FOR PAIN & REHABILITATION MEDICINE

Provider Business Mailing Address
First Line	:	3097 MOORPARK AVE STE 200
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2543
Country	:	US
Telephone Number	:	408-244-7246
Fax Number	:	408-244-7248

Provider Business Practice Location Address
First Line	:	3097 MOORPARK AVE STE 200
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95128-2543
Country	:	US
Telephone Number	:	408-244-7246
Fax Number	:	408-244-7248

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. MICHAEL M JADALI
Credential	:	DO
Telephone Number	:	408-244-7246

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	01/15/2025

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