Organization Name: | JENNIFER MAW, M.D., INC |
NPI Number: | 1194749556 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JENNIFER LESLEY MAW (PRESIDENT) |
Mailing Address: | 3071 Payne Ave San Jose |
State: | CA US |
Postal Code: | 951284054 |
Phone Number: | 4085405400 |
Fax Number: | 4085405419 |
NPI Enumeration Date: | 07/27/2006 |
NPI Last Update Date: | 04/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | A657850 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |