| Jaleh Niazi, M.d., Inc. | |
|
900 Colusa Ave 204 Berkeley CA 94707-2321 | |
| (510) 465-4445 | |
| Not Available |
| Full Name | Jaleh Niazi, M.d., Inc. |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 900 Colusa Ave, Berkeley, California |
| Authorized Official Name and Position | Jaleh Niazi (PRESIDENT) |
| Authorized Official Contact | 5104654445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jaleh Niazi, M.d., Inc. 900 Colusa Ave 204 Berkeley CA 94707-2321 Ph: (510) 465-4445 | Jaleh Niazi, M.d., Inc. 900 Colusa Ave 204 Berkeley CA 94707-2321 Ph: (510) 465-4445 |
| NPI Number | 1518324284 |
|---|---|
| Provider Enumeration Date | 01/26/2016 |
| Last Update Date | 01/26/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518324284 | NPI | - | NPPES |
| 1053300988 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | G79850 (California) | Primary |
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