Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A66564 | CA |
NPI | 1164500997 |
---|---|
Provider Name | James T. Jaing |
First Address | Oakland, CA 94612-3466 |
Second Address | Modesto, CA 95356-9718 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 13/12/2021 |