Provider Demographics
NPI:1043258684
Name:DARYAIE, JALAL ARMAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JALAL ARMAN
Middle Name:
Last Name:DARYAIE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 MERIDIAN AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2905
Mailing Address - Country:US
Mailing Address - Phone:408-971-9999
Mailing Address - Fax:408-971-9165
Practice Address - Street 1:259 MERIDIAN AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2905
Practice Address - Country:US
Practice Address - Phone:408-971-9999
Practice Address - Fax:408-971-9165
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0277380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU91117Medicare UPIN