Provider Demographics
NPI:1346321197
Name:GIRON, JAIME ELIEZER (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:ELIEZER
Last Name:GIRON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:600 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOLEDAD
Mailing Address - State:CA
Mailing Address - Zip Code:93960-2533
Mailing Address - Country:US
Mailing Address - Phone:831-678-2665
Mailing Address - Fax:831-678-1539
Practice Address - Street 1:600 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOLEDAD
Practice Address - State:CA
Practice Address - Zip Code:93960-2533
Practice Address - Country:US
Practice Address - Phone:831-678-2665
Practice Address - Fax:831-678-1539
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA80671207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR011110Medicaid
CARHM53997FMedicaid
CABY819ZMedicare Oscar/Certification
CAGR011110Medicaid