Provider Demographics
NPI:1770579625
Name:JAFFIN, H MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:H
Middle Name:MICHAEL
Last Name:JAFFIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HENRY
Other - Middle Name:MICHAEL
Other - Last Name:JAFFIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3720 SUNSET LANE
Mailing Address - Street 2:SUITE A
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94509-6124
Mailing Address - Country:US
Mailing Address - Phone:925-706-7788
Mailing Address - Fax:925-706-7988
Practice Address - Street 1:3720 SUNSET LANE
Practice Address - Street 2:SUITE A
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94509-6124
Practice Address - Country:US
Practice Address - Phone:925-706-7788
Practice Address - Fax:925-706-7988
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-26
Last Update Date:2009-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG30854207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G30854Medicare ID - Type Unspecified
A44573Medicare UPIN