Provider Demographics
NPI:1457489304
Name:JADALLAH, CARLA MAUREEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:MAUREEN
Last Name:JADALLAH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1720 EL CAMINO REAL
Mailing Address - Street 2:SUITE130
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3224
Mailing Address - Country:US
Mailing Address - Phone:650-692-0977
Mailing Address - Fax:650-259-5840
Practice Address - Street 1:1720 EL CAMINO REAL
Practice Address - Street 2:SUITE130
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3224
Practice Address - Country:US
Practice Address - Phone:650-692-0977
Practice Address - Fax:650-259-5840
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2018-05-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA55390208D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice