Jack H Koumjian
Prosthodontist
770 Welch Rd Ste 280
Palo Alto
, California 94304-1513
Jack H Koumjian
Prosthodontist
770 Welch Rd Ste 280
Palo Alto
, California 94304-1513
(650) 324-0103
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About
Features
Specialties
- Prosthodontist
Languages spoken
- English
Location
First Address
- Jack H Koumjian
- 770 Welch Rd Ste 280
- Palo Alto, CA
- Zip : 94304-1513
- Fax : (650) 324-0103
- Phone : (650) 347-3426
Second Address
- Jack H Koumjian
- 770 Welch Rd Ste 280
- Palo Alto, CA
- Zip : 94304-1513
- Fax : (650) 324-0103
- Phone : (650) 347-3426
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0700X | Prosthodontist | 327301 | CA |
National Provider Identifier
| NPI | 1073629390 |
|---|---|
| Provider Name | Jack H Koumjian |
| First Address | Palo Alto, CA 94304-1513 |
| Second Address | Palo Alto, CA 94304-1513 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 21/08/2006 |
| Last Update Date | 20/12/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1073629390 | DENTICAL (01) | CA |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.