Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204C00000X | Sports Medicine Doctor | 20A9504 | CA |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A9504 | CA |
N | 208100000X | Physical Medicine & Rehabilitation Doctor | 20A9504 | CA |
N | 2081P2900X | Pain Medicine | 20A9504 | CA |
N | 2081S0010X | Sports Medicine | 20A9504 | CA |
N | 213ES0000X | Sports Medicine | 20A9504 | CA |
NPI | 1891723375 |
---|---|
Provider Name | Dr. Michael M Jadali |
First Address | Los Gatos, CA 95030-7210 |
Second Address | Los Gatos, CA 95030-7210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2006 |
Last Update Date | 08/07/2007 |