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NPI Code Detail

MEDICARE: JAYANTA KUMAR PAL MD

MEDICARE: JAYANTA KUMAR PAL 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
12084P0800XPsychiatry Physician25MA07649700NJ
22084P0800XPsychiatry PhysicianC158290CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1992899041
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAYANTA KUMAR PAL MD
Provider Business Mailing Address
First Line : 26284 PASEO SILLIN
Second Line :
City : SAN JUAN CAPISTRANO
State : CA
Zip : 92675-5004
Country : US
Telephone Number : 732-823-2941
Fax Number :
Provider Business Practice Location Address
First Line : 16756 CHINO CORONA RD
Second Line :
City : CORONA
State : CA
Zip : 92880-9508
Country : US
Telephone Number : 732-823-2941
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/03/2006
Last Update Date : 01/19/2025

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