Basic Information
| Provider Information | |||||||||
| NPI: | 1235612078 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHEERAMKUZHIYIL | ||||||||
| FirstName: | AJOOMA | ||||||||
| MiddleName: | JOY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6840 VIA DEL ORO STE 210 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951191372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082842280 | ||||||||
| FaxNumber: | 4087540450 | ||||||||
| Practice Location | |||||||||
| Address1: | 1149 E JULIAN ST BLDG H | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951161005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4085356001 | ||||||||
| FaxNumber: | 4085352348 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2018 | ||||||||
| LastUpdateDate: | 09/21/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 95009605 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.