Provider Demographics
NPI:1598774432
Name:JHA, VINAYAK M (MD)
Entity Type:Individual
Prefix:DR
First Name:VINAYAK
Middle Name:M
Last Name:JHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 CLAY ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-1931
Mailing Address - Country:US
Mailing Address - Phone:415-923-3421
Mailing Address - Fax:415-600-1414
Practice Address - Street 1:2351 CLAY ST
Practice Address - Street 2:SUITE 501
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-1931
Practice Address - Country:US
Practice Address - Phone:415-923-3421
Practice Address - Fax:415-600-1414
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035592207R00000X, 207RC0200X, 207RP1001X
CA131832207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC036945200Medicaid
I24389Medicare UPIN
DC017812M83Medicare ID - Type Unspecified