Provider Demographics
NPI:1891723375
Name:JADALI, MICHAEL M (DO , RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:M
Last Name:JADALI
Suffix:
Gender:M
Credentials:DO , RPH
Other - Prefix:
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Mailing Address - Street 1:221 ALMENDRA AVE
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95030-7210
Mailing Address - Country:US
Mailing Address - Phone:408-354-2300
Mailing Address - Fax:408-354-8772
Practice Address - Street 1:221 ALMENDRA AVE
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95030-7210
Practice Address - Country:US
Practice Address - Phone:408-354-2300
Practice Address - Fax:408-354-8772
Is Sole Proprietor?:No
Enumeration Date:2006-06-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9504204C00000X, 204D00000X, 208100000X, 2081P0004X, 2081P2900X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Not Answered204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Not Answered208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Not Answered2081P0004XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSpinal Cord Injury Medicine
Not Answered2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Not Answered2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine