Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | A70147 | CA |
N | 111NI0900X | Internist | A70147 | CA |
Y | 207RN0300X | Nephrologist | A70147 | CA |
NPI | 1023107257 |
---|---|
Provider Name | Anagha V Jain |
First Address | San Jose, CA 95128-2604 |
Second Address | Redwood City, CA 94063-2037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 20/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A701470 | (05) | CA |
I16533 | (02) | CA |