Mogannam, Jamal Raji
Mogannam, Jamal Raji is an individual health care provider with primary practice located at 1425 S Main St , Walnut Creek CA 94596-5318. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Mogannam, Jamal Raji can be contacted via phone (925) 295-4000.Contact Information
Primary practice address
1425 S Main St
Walnut Creek CA 94596-5318
Phone: (925) 295-4000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | G62129 | California |
Profile Details
| NPI number | 1053483891 |
|---|---|
| LBN Legal business name | Mogannam, Jamal Raji |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 15th, 2006 |
| Last updated | Jan 10th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053483891 | NPPES |
| California | MEDICAID | 00G621290 |
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