Provider Demographics
NPI:1215548193
Name:JALALDIN, ARJUMAND WAJID
Entity Type:Individual
Prefix:
First Name:ARJUMAND
Middle Name:WAJID
Last Name:JALALDIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16467 OAK GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:MORGAN HILL
Mailing Address - State:CA
Mailing Address - Zip Code:95037-9687
Mailing Address - Country:US
Mailing Address - Phone:408-368-9999
Mailing Address - Fax:
Practice Address - Street 1:16467 OAK GLEN AVE
Practice Address - Street 2:
Practice Address - City:MORGAN HILL
Practice Address - State:CA
Practice Address - Zip Code:95037-9687
Practice Address - Country:US
Practice Address - Phone:408-368-9999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-13
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies