Provider Demographics
NPI:1578700332
Name:JUMA, HAITHAM JAMIL (MD)
Entity Type:Individual
Prefix:
First Name:HAITHAM
Middle Name:JAMIL
Last Name:JUMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11234 ANDERSON STREET, CP 21005
Mailing Address - Street 2:HOUSE OF STAFFING
Mailing Address - City:LOMA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92354-2804
Mailing Address - Country:US
Mailing Address - Phone:909-558-8131
Mailing Address - Fax:909-558-0430
Practice Address - Street 1:11234 ANDERSON ST
Practice Address - Street 2:HOUSE OF STAFFING
Practice Address - City:LOMA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92354-2804
Practice Address - Country:US
Practice Address - Phone:909-558-8131
Practice Address - Fax:909-555-8043
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-15
Last Update Date:2009-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1063692083P0500X, 2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine