Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | G033682 | CA |
NPI | 1013006998 |
---|---|
Provider Name | Jeffrey Stephen Javerbaum |
First Address | Menlo Park, CA 94025 |
Second Address | Menlo Park, CA 94025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 31/10/2016 |