Provider Demographics
NPI:1487834479
Name:RASHMI JAIN M D PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:RASHMI JAIN M D PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RASHMI
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-777-0050
Mailing Address - Street 1:1828 EL CAMINO REAL STE 407
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-3115
Mailing Address - Country:US
Mailing Address - Phone:650-777-0050
Mailing Address - Fax:650-777-0052
Practice Address - Street 1:1828 EL CAMINO REAL STE 407
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3115
Practice Address - Country:US
Practice Address - Phone:650-777-0050
Practice Address - Fax:650-777-0052
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-07
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42911207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C429111Medicaid
CAZZZ06322ZMedicare PIN