Basic Information
| Provider Information | |||||||||
| NPI: | 1710937941 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JEFFREY DO MD, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 7793 | ||||||||
| Address2: | |||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941207793 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9259511366 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20998 REDWOOD RD | ||||||||
| Address2: | |||||||||
| City: | CASTRO VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945465918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5105382828 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DO | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 9259511366 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.