Provider Demographics
NPI:1417188061
Name:JAGODZINSKI, JASON EDWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:EDWARD
Last Name:JAGODZINSKI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:550 16TH ST
Mailing Address - Street 2:UCSF ORTHOPAEDIC SURGERY, 5TH FLOOR, BOX 3212
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94158-2549
Mailing Address - Country:US
Mailing Address - Phone:415-514-1519
Mailing Address - Fax:415-476-5363
Practice Address - Street 1:744 52ND ST
Practice Address - Street 2:OPC 1ST FLOOR, ORTHOPAEDICS CLINIC
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-1810
Practice Address - Country:US
Practice Address - Phone:510-428-3885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-30
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA135948207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery