Basic Information
| Provider Information | |||||||||
| NPI: | 1972113397 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KALAW | ||||||||
| FirstName: | JASON | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2280 W EL CAMINO REAL APT 3117 | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940406231 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4809253262 | ||||||||
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| Practice Location | |||||||||
| Address1: | 170 ALAMEDA DE LAS PULGAS | ||||||||
| Address2: | |||||||||
| City: | REDWOOD CITY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940622751 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6503695811 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2020 | ||||||||
| LastUpdateDate: | 08/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 242T00000X | 8833192 | CA | Y | Technologists, Technicians & Other Technical Service Providers | Perfusionist |
No ID Information.