Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 125-055564 | IL |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 34415 | AL |
N | 2080N0001X | Neonatal-Perinatal Doctor | A121694 | CA |
NPI | 1114176237 |
---|---|
Provider Name | Om Jha |
First Address | Mobile, AL 36640-0480 |
Second Address | Mobile, AL 36604-3301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2008 |
Last Update Date | 20/09/2015 |