Basic Information
Provider Information
NPI: 1427491620
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JAJU
FirstName: MINAL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2640 E BARNETT RD # E333
Address2:  
City: MEDFORD
State: OR
PostalCode: 975044301
CountryCode: US
TelephoneNumber: 5412826770
FaxNumber: 5412826771
Practice Location
Address1: 2825 E BARNETT ROAD
Address2:  
City: MEDFORD
State: OR
PostalCode: 975040001
CountryCode: US
TelephoneNumber: 5412826770
FaxNumber: 5412826771
Other Information
ProviderEnumerationDate: 04/08/2013
LastUpdateDate: 10/24/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000XMD161945ORN Allopathic & Osteopathic PhysiciansInternal Medicine 
208M00000XMD161945ORY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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