Provider Demographics
NPI:1356573398
Name:A. K. JAFFER MD. INC.
Entity type:Organization
Organization Name:A. K. JAFFER MD. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:A. KAREEM
Authorized Official - Middle Name:
Authorized Official - Last Name:JAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:951-658-2218
Mailing Address - Street 1:2 UPPER RAGSDALE DR
Mailing Address - Street 2:SUITE NO.# B-240
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5736
Mailing Address - Country:US
Mailing Address - Phone:831-642-9800
Mailing Address - Fax:831-642-9700
Practice Address - Street 1:2 UPPER RAGSDALE DR
Practice Address - Street 2:SUITE NO.# B-240
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5736
Practice Address - Country:US
Practice Address - Phone:831-642-9800
Practice Address - Fax:831-642-9700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-10
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00A3362602084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A336260Medicaid
CAA87902Medicare UPIN