Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036.119307 | IL |
N | 111NI0900X | Internist | 036.119307 | IL |
Y | 207RH0002X | Hospice and Palliative Medicine | C130571 | CA |
NPI | 1205085958 |
---|---|
Provider Name | Udai Jayakumar |
First Address | Harbor City, CA 90710-3518 |
Second Address | Harbor City, CA 90710-3518 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2008 |
Last Update Date | 01/12/2021 |