Provider Demographics
NPI:1558071696
Name:UDAY JAIN M D PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:UDAY JAIN M D PROFESSIONAL CORPORATION
Other - Org Name:UDAY JAIN, M.D., PROFESSIONAL CORPORATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:UDAY
Authorized Official - Middle Name:
Authorized Official - Last Name:JAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-430-0017
Mailing Address - Street 1:505 CHATEAU DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:CA
Mailing Address - Zip Code:94010-6501
Mailing Address - Country:US
Mailing Address - Phone:650-430-0017
Mailing Address - Fax:650-348-6866
Practice Address - Street 1:2222 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95050-2904
Practice Address - Country:US
Practice Address - Phone:408-988-0105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty