Provider Demographics
NPI:1518324284
Name:JALEH NIAZI, M.D., INC.
Entity Type:Organization
Organization Name:JALEH NIAZI, M.D., INC.
Other - Org Name:NEW DAY PEDIATRICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JALEH
Authorized Official - Middle Name:
Authorized Official - Last Name:NIAZI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-465-4445
Mailing Address - Street 1:900 COLUSA AVE
Mailing Address - Street 2:204
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94707-2321
Mailing Address - Country:US
Mailing Address - Phone:510-465-4445
Mailing Address - Fax:
Practice Address - Street 1:900 COLUSA AVE
Practice Address - Street 2:204
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94707-2321
Practice Address - Country:US
Practice Address - Phone:510-465-4445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-26
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79850261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1053300988Medicaid