Provider Demographics
NPI:1740306703
Name:JAY GARFINKLE, M.D. A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:JAY GARFINKLE, M.D. A PROFESSIONAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:M
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:GARFINKLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-780-9148
Mailing Address - Street 1:27225 CALAROGA AVE
Mailing Address - Street 2:
Mailing Address - City:HAYWARD
Mailing Address - State:CA
Mailing Address - Zip Code:94545-4338
Mailing Address - Country:US
Mailing Address - Phone:510-780-9148
Mailing Address - Fax:510-780-9149
Practice Address - Street 1:27225 CALAROGA AVE
Practice Address - Street 2:
Practice Address - City:HAYWARD
Practice Address - State:CA
Practice Address - Zip Code:94545-4338
Practice Address - Country:US
Practice Address - Phone:510-780-9148
Practice Address - Fax:510-780-9149
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG22474208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G224740Medicaid
CA00G224740Medicare PIN